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Every year, a million children die from malaria — partly because ineffective antimalarial drugs continue to be used. But with strong and focused leadership the tide can be turned on this killer disease, says Nicholas White in this article.

The cheap antimalarial chloroquine has been the drug of choice for most developing nations over the past half century. Now, however, the drug is ineffective in many countries because the malaria parasite has developed a widespread resistance to it.

New results from a clinical trial in Malawi, which stopped using chloroquine in 1993, show that the drug can regain its potency if it is withdrawn from use (see Chloroquine works again, but scientists urge caution).

The drug would then be able to rejoin the queue of candidate antimalarial agents by being used in combination with other treatments, says White.

But first, he adds, effective alternatives — artemisinin-based combination treatments — must be made available in regions where malaria is endemic, at no more than 10 cents a day.

Richer countries will need to pay for this effort but it will not cost much, argues White: the tools to eradicate malaria are already available.

Link to full article in New England Journal of Medicine