This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Services
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Right arrowReprints and Permissions
Right arrow Copyright Information
Right arrow Books from ASM Press
Right arrow MicrobeWorld
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Winstanley, P.
Right arrow Articles by Breckenridge, A.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Winstanley, P.
Right arrow Articles by Breckenridge, A.

 Previous Article  |  Next Article 

Clinical Microbiology Reviews, July 2004, p. 612-637, Vol. 17, No. 3
0893-8512/04/$08.00+0     DOI: 10.1128/CMR.17.3.612-637.2004
Copyright © 2004, American Society for Microbiology. All Rights Reserved.

Therapy of Falciparum Malaria in Sub-Saharan Africa: from Molecule to Policy

Peter Winstanley,1* Stephen Ward,2 Robert Snow,3 and Alasdair Breckenridge1

Department of Pharmacology & Therapeutics, University of Liverpool, Liverpool L69 3GE,1 Department of Parasitology, Liverpool School of Tropical Medicine, Liverpool L3 5QA, United Kingdom,3 Department of Tropical Public Health, Wellcome Centre for Tropical Medicine, University of Oxford & Kenya Medical Research Institute—Wellcome Trust Collaborative Programme, Nairobi 0100 GPO, Kenya2

The burden of falciparum malaria remains as great as ever, and, as has probably always been the case, it is carried mainly by tropical Africa. Of the various means available for the control of malaria, the use of effective drugs remains the most important and is likely to remain so for a considerable time to come. Unfortunately, the extensive development of resistance by the parasite threatens the utility of most of the affordable classes of drug: the development of novel antimalarials has never been more urgently needed. Any attempt to understand the vast complexities of falciparum malaria in Africa requires an ability to think "from molecule to policy." In consequence, the review ambitiously tries to examine the current pharmacopeia, the process by which new drugs are developed and the ways in which drugs are actually used, in both the formal and informal health sectors. The informal sector is particularly important in Africa, where around half of all antimalarial treatments are bought from informal outlets and taken at home without supervision by health care professionals: the potential impact of adherence on clinical outcome is discussed. Given that the full costs are carried by the patient in a large proportion of cases, the importance of drug affordability is explored. The review also discusses the splicing of new drugs into national policy. The various parameters that feed into deliberations on changes in drug policy are discussed.

* Corresponding author. Mailing address: Department of Pharmacology & Therapeutics, University of Liverpool, Liverpool L69 3GE, United Kingdom. Phone: 44 151 794 5544. Fax: 44 151 794 4222. E-mail: Peterwin{at}liv.ac.uk.

Clinical Microbiology Reviews, July 2004, p. 612-637, Vol. 17, No. 3
0893-8512/04/$08.00+0     DOI: 10.1128/CMR.17.3.612-637.2004
Copyright © 2004, American Society for Microbiology. All Rights Reserved.



This article has been cited by other articles:

  • Balu, B., Shoue, D. A., Fraser, M. J. Jr., Adams, J. H. (2005). High-efficiency transformation of Plasmodium falciparum by the lepidopteran transposable element piggyBac. Proc. Natl. Acad. Sci. USA 102: 16391-16396 [Abstract] [Full Text]  
  • Winstanley, P. (2005). This World: Bad Medicine. BMJ 331: 165-165 [Full Text]  


Copyright © 2009 by the American Society for Microbiology.   For an alternate route to Journals.ASM.org, visit: http://intl-journals.asm.org | More Info»