The Strategy to respond to antimalarial drug resistance in Africa is a technical and advocacy document, grounded in the best available evidence to date and aimed at minimizing the threat and impact of antimalarial drug resistance of Plasmodium falciparum parasites in Africa. Its objectives are to: i) improve the detection of resistance to ensure a timely response; ii) delay the emergence of resistance to artemisinin and artemisinin-based combination therapy (ACT) partner drugs; and iii) limit the selection and spread of resistant parasites where resistance has been confirmed.

For more than 50 years, low-cost antimalarial drugs silently saved millions of lives and cured billions of debilitating infections. Today, however, these drugs no longer work against the deadliest form of malaria that exists throughout the world. Malaria deaths in sub-Saharan Africaâ€"currently just over one million per yearâ€"are rising because of increased resistance to the old, inexpensive drugs. Although effective new drugs called "artemisinins" are available, they are unaffordable for the majority of the affected population, even at a cost of one dollar per course. Saving Lives, Buying Time: Economics of Malaria Drugs in an Age of Resistance examines the history of malaria treatments, provides an overview of the current drug crisis, and offers recommendations on maximizing access to and effectiveness of antimalarial drugs. The book finds that most people in endemic countries will not have access to currently effective combination treatments, which should include an artemisinin, without financing from the global community. Without funding for effective treatment, malaria mortality could double over the next 10 to 20 years and transmission will intensify.

On 4, 5 and 7 March 2024, the WHO Malaria Policy Advisory Group (MPAG) convened in Yaoundé, Cameroon, to review updates and progress, and to provide guidance on thematic areas of work by the Global Malaria Programme. The meeting focused on the following topics: malaria vaccine introduction and scale-up, and the Gavi-supported malaria learning agenda; the High burden to high impact (HBHI) approach; subnational tailoring; biological threats to vector control in Africa; the strategy to respond to antimalarial drug resistance in Africa; the development of guidelines recommendations on tafenoquine, primaquine and near-patient glucose-6-phosphate dehydrogenase (G6PD) diagnostic tests to support radical cure of Plasmodium vivax; and malaria elimination, including zoonotic malaria.

The World Health Organization's Global Technical Strategy for Malaria 2016- 2030 has been developed with the aim to help countries to reduce the human suffering caused by the world's deadliest mosquito-borne disease. Adopted by the World Health Assembly in May 2015 it provides comprehensive technical guidance to countries and development partners for the next 15 years emphasizing the importance of scaling up malaria responses and moving towards elimination. It also highlights the urgent need to increase investments across all interventions - including preventive measures diagnostic testing treatment and disease surveillance- as well as in harnessing innovation and expanding research. By adopting this strategy WHO Member States have endorsed the bold vision of a world free of malaria and set the ambitious new target of reducing the global malaria burden by 90% by 2030. They also agreed to strengthen health systems address emerging multi-drug and insecticide resistance and intensify national cross-border and regional efforts to scale up malaria responses to protect everyone at risk.

"Resistance to antimalarial drugs challenges our ability to save lives threatened by malaria, and to eliminate the burden that malaria places on individuals and societies. This burden is substantial, with malaria having caused an estimated 228 million cases and 405 000 deaths in 2018 (1). The Global technical strategy for malaria 2016–2030, adopted at the World Health Assembly in 2015, highlights the potential of antimalarial drug resistance to seriously weaken the effectiveness of malaria responses and erode the gains achieved (2). Monitoring antimalarial drug efficacy and resistance is important for the early detection of resistance, which in turn enables timely action to prevent its spread and limit the impact on global health. Measurement of drug efficacy and resistance in malaria is complex. Studies of clinical and parasitological outcomes are the main sources of information on which national malaria control programmes base treatment policy; however, other studies are needed to confirm drug resistance if suspected." -- Introduction.

Each year, WHO’s World malaria report offers in-depth information on the latest trends in malaria control and elimination at global, regional and country levels. The report highlights progress towards global targets and describes opportunities and challenges for curbing and eliminating the disease. This year’s report includes three new sections on: (1) global and regional initiatives launched in 2021 and 2022; (2) global malaria surveillance and country-level case studies on surveillance systems assessments; and (3) research and development. The report also includes an expanded section on threats to malaria control, with a focus on the declining effectiveness of insecticide-treated mosquito nets.

On 18–20 April 2023, the WHO Malaria Policy Advisory Group (MPAG) convened to review updates and progress, and to provide guidance on thematic areas of work by the Global Malaria Programme. The meeting focused on the following topics: 1) the RBM Partnership to End Malaria evaluation of the “High burden to high impact” (HBHI) approach; 2) updates on the vector control, treatment and diagnostic recommendations in the WHO guidelines for malaria; 3) revisiting comparative effectiveness in the context of the arrival of new vector control products; 4) an update on certification of malaria elimination and the E-2025 Global Forum; 5) an update on the RTS,S/AS01 Malaria Vaccine Implementation Programme and WHO evidence review for the R21/Matrix-M vaccine; 6) an update on the work areas of the Strategic Information for Response Unit; 7) a report from the technical consultation on the effectiveness of rectal artesunate (RAS) and field implementation manual; 8) a report from the technical consultation on community-based delivery of intermittent preventive treatment of malaria in pregnancy (IPTp); 9) an update on the WHO/TDR field implementation manual for seasonal malaria chemoprevention (SMC); 10) an update on the Anopheles stephensi regional strategy; 11) an update on histidine-rich protein 2 (HRP2) gene deletions and global response plan; and 12) an update on antimalarial drug resistance in Africa.