Arjen Dondorp, deputy director of the Mahidol Oxford Tropical Research Unit at Mahidol University in Bangkok, Thailand, and colleagues discuss the need to combat antimalarial drug resistance in this New England Journal of Medicine opinion piece, writing, “Researchers, funders, and policy leaders must recognize the urgency of the problem, take action to address simultaneously several important knowledge gaps, and focus immediately on eliminating the threat of artemisinin resistance.”

“Additional interventions beyond conventional malaria-control measures are needed,” the authors write, stressing the importance of removing oral artemisinin-based monotherapies — major drivers of the spread of resistance — and counterfeit or falsified antimalarial drugs from the market, as well as increasing research on the biology of artemisinin-resistant Plasmodium falciparum parasites. They write, “Losing artemisinins to resistance will not only jeopardize the goal of malaria eradication, but will also result in large increases in African childhood mortality like those that occurred during the last century when chloroquine failed against newly evolved drug-resistant parasites” (9/22).