Eliminating malaria to counter artemisinin resistance. (360G-Wellcome-101148_Z_13_Z)

Artemisinin resistance in falciparum malaria poses the greatest threat to current global initiatives to control and eliminate malaria. Urgent action to contain this threat is needed, but there is no consensus on what containment measures should be undertaken. We propose a multinational clinical and laboratory project to evaluate targeted chemo-elimination (TCE) as a strategy to eliminate artemisinin resistant Plasmodium falciparum. In areas where artemisinin resistant falciparum malaria has been identified we will measure the impact of repeated TCE on the incidence of malaria, the size and the genetic structure of the malaria parasite population and on the transmission of malaria, and the progression of artemisinin resistance. We will develop and refine the epidemiological methods of assessment and assess the acceptability, safety, effectiveness, costs and feasibility of TCE and thereby provide tools for scale-up if it is proved effective.