Final drug development requires teaming with a commercial partner who contributes to financing in the late stages, before or at the time of clinical trials.

MMV is the main driver of antimalarial drug projects, with many public- and private-sector collaborators. Projects closest to completion are, not surprisingly, several fixed-dose artemisinin combinations. Their likely registration dates, if successful, will be 2006-2007. The large number of fixed-dose combinations in development is currently justified, but as they progress, some may begin to appear more relevant than others. Factors that will influence this are: efficacy, safety, cost, stability, speed of development, and availability. Combinations in development include:

• Chlorproguanil-dapsone-artesunate (Lapdap-artesunate) by GSK with WHO/TDR, and MMV. Phase 2 studies initiated.

• Pyronaridine-artesunate by Shin Poong, Korea, in collaboration with WHO/TDR and MMV (MMV funded). Phase 1 planned for early 2004.

• Piperaquine-dihydroartemisinin (Artekin II) by Holleykin, China. Already marketed in Asia, but not registered in Europe or Africa. Following

Front Matter (R1-R20)

Executive Summary (1-16)

Part 1: A Response to the Current Crisis1 Malaria Today (17-60)

2 The Cost and Cost-Effectiveness of Antimalarial Drugs (61-78)

3 The Case for a Global Subsidy of Antimalarial Drugs (79-111)

4 An International System for Procuring Anitmalarial Drugs (112-122)

Part 2: Malaria Basics5 A Brief History of Malaria (123-135)

6 The Parasite, the Mosquito, and the Disease (136-167)

7 The Human and Economic Burden of Malaria (168-196)

8 Malaria Control (197-251)

9 Antimalarial Drugs and Drug Resistance (252-298)

Part 3: Advancing Toward Better Malaria Control10 Research and Development for New Antimalarial Drugs (299-311)

11 Maximizing the Effective Use of Antimalarial Drugs (312-328)

Acronyms and Abbreviations (329-333)

Glossary (334-346)

Index (347-364)