Triple artemisinin-based combination therapies for malaria: a timely solution to counter antimalarial drug resistance

Drug resistance against antimalarials is inevitable, usually emerging slowly for approximately 20 years after they start being widely used, at which point there is a sudden onset of widespread resistance. 

This pattern has been seen for chloroquine, sulfadoxine-pyrimethamine, and most recently the components of artemisinin-based combination therapy (ACT), emphasising the need for a robust antimalarial drug pipeline featuring compounds with novel modes of action until global malaria eradication is achieved. While we await new compounds—seven of which are in translational and human exploratory studies but might fail at later stages of the pipeline —additional strategies are urgently needed to curb the persistent and rapid emergence of resistance to artemisinin-class and partner drugs.