Anti-malaria drug resistance is a pressing public health threat that endangers the gains Africa has achieved in malaria control and elimination efforts over the previous decades. Malaria, especially severe malaria, which claims over 600,000 lives globally each year, remains a critical global health threat. This is especially relevant in the African context, as over 90 percent of severe malaria deaths occur in the region.
At present, the first-line national treatment regimens for uncomplicated malaria in Africa are ACTs, primarily artemether–lumefantrine or artesunate–amodiaquine, and the standard therapy for severe malaria is intravenous artesunate. However, the threat of artemisinin resistance and potential loss of treatment efficacy could escalate yearly global malaria deaths to epidemic levels, posing a major health security threat in Africa, if the issue is not treated with urgency. Some of the most malaria endemic countries in East Africa have reported the presence of resistance genes to current treatments to malaria. Studies in West and East Africa for measuring the efficacy of artemether–lumefantrine, the gold standard for malaria treatment, have reported lower than desired drug efficacy levels raising concerns. Several partnership initiatives on anti-malarial resistance and severe malaria have been developed to help address some of the threats described above.