Abstract:
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Since 2000, the world has made significant progress in reducing
malaria morbidity and mortality, and several countries in
Africa, South America and South-East Asia are working hard to
eliminate the disease. These elimination efforts continue to
rely heavily on antimalarial drugs and insecticide-based
interventions, which remain the cornerstones of malaria
treatment and prevention. However, resistance has emerged
against nearly every antimalarial drug and insecticide that is
available. In this review we discuss the evolutionary
consequences of the way we currently implement antimalarial
interventions, which is leading to resistance and may ultimately
lead to control failure, but also how evolutionary principles
can be applied to extend the lifespan of current and novel
interventions. A greater understanding of the general
evolutionary principles that are at the core of emerging
resistance is urgently needed if we are to develop improved
resistance management strategies with the ultimate goal to
achieve a malaria-free world. |