This clearly written review examines many current questions about using Intermittent Preventive Treatment (IPT) in pregnant women or in infants to reduce the numbers of clinical episodes and deaths due to malaria. Treatment is given at fixed time intervals regardless of whether the person is infected. This means that there is enough time after the drugs have cleared from the body to allow infections to occur and permit a build-up of immunity. The review refers to recent clinical trials on IPT in pregnant women and infants to discuss factors that could affect the outcome of the treatment. These include the intensity of malaria transmission, the choice of drugs, and the use of other prevention measures such as insecticide-treated nets.

 In this report, the World Health Organization (WHO) warns that vigilance is needed to prevent drug-resistant malaria arising from the widescale introduction of artemisin combination therapies (ACTs) for malaria. More than 50 countries have now adopted ACTs, and they must closely monitor the effectiveness of these drugs and check for the emergence of resistance, the report concludes. Patients should receive only WHO-approved high-quality medicines to minimise the risk of resistance emerging, and should be encouraged to complete their treatment courses. The report outlines the WHO's commitment to helping establish stardardised laboratory procedures, and strengthening resistance monitoring networks.

For this report, malaria and HIV/AIDS specialists were consulted on interactions between the two diseases and how having both affects people's health. They said there is still much to learn about the biological and clinical effects that malaria and HIV/AIDS have on each other. But some conclusions are already clear: integrating healthcare services is essential to reducing the burden of both diseases where they are prevalent. Health services providing HIV/AIDS prevention, treatment and care can serve as access points for malaria prevention and control. Likewise, new laboratory capacity to support HIV treatment and monitoring can also be used for malaria diagnosis. More research and debate is needed, however, before formulating new public health policies. 

For this report, malaria and HIV/AIDS specialists were consulted on interactions between the two diseases and how having both affects people's health. They said there is still much to learn about the biological and clinical effects that malaria and HIV/AIDS have on each other. But some conclusions are already clear: integrating healthcare services is essential to reducing the burden of both diseases where they are prevalent. Health services providing HIV/AIDS prevention, treatment and care can serve as access points for malaria prevention and control. Likewise, new laboratory capacity to support HIV treatment and monitoring can also be used for malaria diagnosis. More research and debate is needed, however, before formulating new public health policies. 

The World Health Organization recommends artemisinin combination therapies (ACTs) to treat malaria, but these therapies cost much more than older drugs such as chloroquine. This report by the US Institute of Medicine's Committee on the Economics of Antimalaria Drugs calls for an internationally funded global subsidy of US$300–500 million per year to provide ACTs to everyone needing them. A centralised agency should be set up, the report says, to buy ACTs from recommended producers and re-sell them at substantially lower prices to public and private organisations for distribution. Recipient countries should monitor drug distribution and the emergence of drug-resistant malaria parasites. The report is available free online. 

This article introduces a special collection of contributions by malaria researchers from around the world, including some information first presented at a symposium in Tanzania in 2002. The article is a useful overview of malaria's global impact and our current understanding of mosquito ecology and parasite transmission. It describes new measures needed to combat and eventually eliminate malaria. The full supplement — freely available online, in print or on DVD — features articles on how well artemisinin combination therapies treat malaria and delay the emergence of drug-resistant parasites, how useful insecticide-treated bed nets are, and progress towards a vaccine. It also covers social and economic dimensions of malaria, and how they affect the scaling up and use of existing prevention and control measures.

This article introduces a special collection of contributions by malaria researchers from around the world, including some information first presented at a symposium in Tanzania in 2002. The article is a useful overview of malaria's global impact and our current understanding of mosquito ecology and parasite transmission. It describes new measures needed to combat and eventually eliminate malaria. The full supplement — freely available online, in print or on DVD — features articles on how well artemisinin combination therapies treat malaria and delay the emergence of drug-resistant parasites, how useful insecticide-treated bed nets are, and progress towards a vaccine. It also covers social and economic dimensions of malaria, and how they affect the scaling up and use of existing prevention and control measures.

This article is a call for radically improved communication about the dangers of substandard and fake drugs, particularly in poor countries. This is currently a "vast and underreported problem" that the pharmaceutical industry fails to address, and it should be monitored independently, say the authors. Using examples of fake drug sales in Africa and Asia, they argue that without action, lives will remain at risk, and public confidence in the pharmaceutical industry will be undermined in the long term.

The London School of Hygiene and Tropical Medicine's Gates MalariaIntermittent Presumptive Treatment (IPT) is a recently developed strategy for preventing sickness and death from severe malaria. It involves giving a curative treatment dose of an effective anti-malarial drug at predefined intervals to pregnant women and infants. In this article, Nick White, director of the Wellcome Trust South East Asia Programme in Thailand and Vietnam, and advisor on SciDev.Net's malaria dossier argues that to guide policymakers on promoting and implementing IPT, more information is needed on how it works. White uses some technical terms but expresses clearly his concerns about issues such as how long drugs remain effective after each treatment, as this determines whether IPT can ward off or suppress new infections. He also discusses parasite resistance to drugs currently used in IPT and the rationale for using new antimalarial drugs.

A future malaria vaccine, if licensed, is likely to be far from perfect — it could cost dollars not cents, and might be far less than 100 per cent effective. This article, explores a hypothetical scenario of a new malaria vaccine being only 30–50 per cent effective. It illustrates the hard decisions policymakers will need to make when trying to allocate funds for malaria prevention and control to only the most cost-effective measures. To inform decision-making, research is needed on how different vaccines would affect malaria epidemics and at what cost, as well as to determine a vaccine delivery mechanism. The article is likely to appeal to non-specialist readers more than some other papers in this special supplement.

Insecticide-treated bednets can kill mosquitoes and are central to the Roll Back Malaria partnership's strategy for preventing malaria. But the nets are not yet accessible to many of those who need them. This document highlights discussions from a workshop in May 2003 on how to best use public funds to make these nets widely available. Participants included representatives of African health ministries and national malaria control programmes, major donors, non-governmental organisations and the private sector. The report summarises lessons learned using different strategies to subsidise the purchase of treated bednets. These include long-term targeted subsidies for the most vulnerable groups — pregnant women and children — as well as short-term subsidies to supply and support viable commercial markets. The report is intended to help countries assess their own needs and plan appropriately.