Tackling the Problem of Antimalarial Resistance

The emergence and spread of resistance remain a burgeoning problem in the control and the management of malaria. Effort has been dedicated in discovering and developing new drugs; however, these efforts are hampered by the rapid selection of resistance. For instance, there is no single antimalarial in clinical use against which the parasite has not yet developed resistance. To counterbalance this rapid development of resistance, not only should new drugs be developed, but the mechanisms of resistance to existing drugs need to be fully understood. Indeed, understanding these mechanisms could lead to identifying simple ways, by the use of single markers, to map and monitor the emergence and spread of drug resistance. In addition, such studies could also contribute to clarifying the mode of action drug, which eventually could lead to the discovery of new targets and thus new drugs. In this chapter, we have reviewed our current knowledge and presented existing challenges and gaps, on the mechanisms of resistance to most clinically important antimalarials.