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Card Consolidation Credit Debt       522 Faculty of Tropical Medicine AVERTING A MALARIA DISASTER White NJ¹, Nosten F¹, Looareesuwan S², Watkin WM³, Marsh K³, Snow RW³, Kokwaro G³, Ouma J⁴, Hien TT⁵, Molyneux ME^6,7, Taylor TE^6,8, Newbold CI⁹, Ruebush TK¹⁰, Danis M¹¹, Greenwood BM¹², Anderson RM¹³, Olliaro P ^{14 1}Wellcome-Mahidol University Oxford Tropical Medicine Research Programme, Mahidol, University, Thailand; ²Faculty of Tropical Medicine, Mahidol University, Thailand; ³KEMRI-Wellcome Trusst Collaborative Research Programme, Ministry of Health, Kenya; ⁴National Malaria Control Programme, Ministry of Health, Kenya; ⁵ Centre for Tropical Diseases, Cho Quan Hospital, Ho Chi Minh City, Vietnam.⁶College of Medicine, University of Malawi, Malawi; ⁷Liverpool School of Tropical Medicine, Liverpool, UK. ⁸College of Osteopathic Medicine, Michigan, USA; ⁹Molecular Parasitology, Institute of Molecular Medicine, University of Oxford, Oxford, UK; ¹⁰Centers for Diseases Control and Prevention, Atlanta, Georgia, USA; ¹¹Groupe Hospitalier Pitie-Salpetriere, Paris, France; ¹²London School of Hygiene and Tropical Medicine, London, ¹³Department of Zoology, University of Oxford, Oxford, UK, ¹⁴World Health Organization, Geneva, Switzerland.

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Merchant Credit Guide Co                    Estimates for the annual mortality from malaria range from 0.5 to 2.5 million deaths. The burden of this enormous toll, and the concomitant morbidity, is borne by the world's poorest countries. Malaria morbidity and mortality have been held in check by the widespread availability of cheap and effective antimalarial drugs. The loss of these drugs to resistance my represent the single most important threat to the health of people in tropical countries. Chloroquine has been the mainstay of antimalarial drug treatment for the past 40 years, but resistance is now wedespread and few countries are unaffected. Pyrimethamine-salphadoxine (PSD) is usually deployed as a successor to chloroquine. Both these antimalarials cost less than US$0.20 per adult treatment course, but the drugs required to treat multidrug-resistant falciparum malaria (quinine, mefloquine, halofantrine) are over ten times more expensive and cannot be afforded by most tropical countries especially those in Africa, where it is estimated that more than 90% of the world's malaria deaths occur. Resistance to chloroquine is widespread across Africa and resistance to PSD is increasing. A health calamity looms within the next few years. As treatments lose their effectiveness, morbidity and mortality from malaria will inevitably continue to rise. Can this disaster be prevented? Can we really "roll back malaria", as the new Director-General of WHO has demanded?

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By Card Credit Debt Debt Guide (The study was supported by the Wellcome Trust, Oxford Tropical Medicine Research Programme, 183 Euston Road London NW1 2BE, UK. Published in: Lancet, 1999;353(5):1965-7.)

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