# Artemisinin resistance threat in Central and West Africa needs holistic action

## TL;DR

Artemisinin resistance is spreading in Central and West Africa, requiring urgent and comprehensive action to prevent public health and economic impacts.

## Contribution

The paper highlights the growing threat of artemisinin resistance in Central and West Africa and proposes strategies for surveillance and mitigation.

## Key findings

- Artemisinin resistance is emerging in Central and West Africa, linked to mutations in the Plasmodium falciparum kelch13 gene.
- Funding cuts and armed conflicts threaten malaria control efforts in the region.
- Near real-time surveillance systems are proposed to enhance data use and guide tailored control strategies.

## Abstract

Artemisinin partial resistance (ART-R) has now emerged in the Horn, Eastern and Southern Africa. Mutations in the Plasmodium falciparum kelch13 gene, strongly associated with ART-R, are increasingly reported in several Central and West Africa countries. Here, we opine that the emergence and spread of ART-R in Central and West Africa should not be overlooked given public health, clinical and economic consequences. Again, in addition to the recent funding cuts from the United States (US) government, some regions in these countries are affected by armed conflicts that undoubtedly will disrupt malaria control measures. Thus, measures should be proactively taken to prevent the emergence of ART-R or mitigate its spread in these two regions. We also propose strategies that could be valuable in implementing a near real-time surveillance and information system, will produce high-quality analysis, allow to draw malaria reality-reflecting conclusions, optimally enhance data use and define tailored control and elimination strategies.