Combination therapy is a cornerstone of modern malaria treatment, particularly in the context of widespread multidrug resistance. Using two or more antimalarial drugs with different mechanisms simultaneously enhances efficacy, shortens treatment duration, improves compliance and delays the developme...nt of resistance. Artemisinin-based combination therapies (ACTs), such as artemether–lumefantrine, artesunate–amodiaquine and artesunate–sulfadoxine/pyrimethamine, are highly effective in rapidly clearing parasites and reducing gametocyte carriage. They are also generally well tolerated. Non-artemisinin combinations, quinine-based regimens and novel combinations (e.g. piperaquine–dihydroartemisinin) offer alternative therapeutic options, although clinical experience with these remains limited. Although ACTs are the preferred first-line treatment, factors such as cost, local drug resistance patterns, safety during pregnancy and paediatric use must inform implementation and policy decisions.
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Human African Trypanosomiasis (HAT, sleeping sickness) and Animal African Trypanosomiasis (AAT) are neglected tropical diseases generally caused by the same etiological agent, Trypanosoma brucei. Despite important advances in the reduction or disappearance of HAT cases, AAT represents a risky reserv...oir of the infections. There is a strong need to control AAT, as is claimed by the European Commission in a recent document on the reservation of antimicrobials for human use. Control of AAT is considered part of the One Health approach established by the FAO program against African Trypanosomiasis. Under the umbrella of the One Health concepts, in this work, by analyzing the pharmacological properties of the therapeutic options against Trypanosoma brucei spp., we underline the need for clearer and more defined guidelines in the employment of drugs designed for HAT and AAT. Essential requirements are addressed to meet the challenge of drug use and drug resistance development. This approach shall avoid inter-species cross-resistance phenomena and retain drugs therapeutic activity.
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The recommendations in these guidelines promote the use of simple, non-invasive diagnostic tests to assess the stage of liver disease and eligibility for treatment; prioritize treatment for those with most advanced liver disease and at greatest risk of mortality; and recommend the preferred use of n...ucleos(t)ide analogues with a high barrier to drug resistance (tenofovir and entecavir, and entecavir in children aged 2–11 years) for first- and second-line treatment. Recommendations for the treatment of HBV/HIV-coinfected persons are based on the WHO 2013 Consolidated guidelines on the use of antiretroviral drugs for treating and preventing HIV infection, which will be updated in 2015.
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The Practical manual on laboratory strengthening, 2022 update provides practical guidance on implementation of WHO recommendations and best practices for TB laboratory strengthening. It is an updated version of the GLI Practical Guide to Laboratory Strengthening published in 2017 and provides the la...test practical guidance on use of newly recommended diagnostics as well as guidance in key technical areas, including quality assurance and quality management systems, specimen collection and registration, procurement and supply-chain management, diagnostic connectivity, biosafety, data management, human resources, strategic planning, and model algorithms. The key changes are:
inclusion of recent or updated WHO recommendations for tests to diagnose TB and detect drug resistance;
alignment with the latest WHO critical concentrations for phenotypic drug-susceptibility testing (DST) and the new definitions of pre-XDR-TB and XDR-TB;
updated information on building quality-assured TB testing and management capacity using the Stepwise Laboratory Quality Improvement Process Towards Accreditation (SLIPTA) approach (Score-TB package1);
updated information on assessing, analysing and optimising TB diagnostic networks; and
updated information on the use of next-generation sequencing (NGS) to detect mutations associated with drug resistance for surveillance purposes.
The document also provides references to resources and tools relevant for work on laboratory strengthening.
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Clinical guideline, Methods, Evidence and Recommendations
In this guideline the following is covered: information needs of people with chronic hep
titis B and their carers; where children, young people and adults with chronic hepatitis B a-
should be assessed; assessment of liver disease, includi...ng the use of non-invasive tests and genotype testing; criteria for offering antiviral treatment; the efficacy, safety and cost effectiveness of currently available treatments; selection of first-line therapy; management of treatment failure or drug resistance; prophylactic treatment during im-
munosuppressive therapy; and monitoring for treatment response
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This chapter discusses the antibacterial treatment of leprosy infections. Antibiotic treatment is
a key component of leprosy treatment, as it is vital to prevent the progression of the infection.
Treatment with rifampin and other antibiotics is highly effective and cures 98% of patients with
the ...leprosy infection. Furthermore, the relapse rate is very low, at about 1% over 5–10 years.
There is little M. leprae drug resistance in leprosy and few reports of multi-drug resistance (1, 2, 3,
4, 5, 6, 7, 8). An antibiotic treatment may take months or years to produce clinical improvement,
especially in patients with an initial high bacterial index (BI).
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It is essential that all people, including people living with HIV, are able to access health services and ongoing treatment. If people living with HIV who are on ART stop abruptly because they cannot access new supplies they could rapidly become unwell, drug resistance may build and the chances of o...nward transmission of the virus would increase.
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These guidelines are based on the 3rd Edition of the WHO Guidelines (Published 2015) World Health Organization’s Guidelines for the treatment of malaria. Additional literature surveys have been undertaken. Factors that were considered in the choice of therapeutic options included effectiveness, sa...fety, and impact on malaria transmission and on the emergence and spread of antimalarial drug resistance. On-going surveillance is critical given the spread of artemisinin resistance in Southeast Asia, although not yet confirmed anywhere in Africa. The guidelines on the treatment of malaria in South Africa aim to facilitate effective, appropriate and timeous treatment of malaria, thereby reducing the burden of this disease in our communities. This is essential to further reduce the malaria case fatality rates currently recorded in South Africa, to decrease malaria transmission and to limit resistance to antimalarial drugs.
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This Implementation Kit (I-Kit), developed by the Health Communication Capacity Collaborative (HC3), helps national and local stakeholders to design country-specific social and behavioural change communication (SBCC) campaigns that address the threat posed by substandard, spurious, falsified and fal...sely labelled (SSFFC) malaria medicines. These poor-quality medicines endanger lives by failing to treat malaria effectively, undermine health systems, and contribute to drug resistance.
The I-Kit provides practical guidance and resources in six sections, including global examples, campaign design elements, media engagement strategies and tools for knowledge sharing. It is intended for health promotion officers, drug regulators, communication specialists and global health partners. Drawing heavily on experiences in Nigeria, the I-Kit promotes evidence-based, context-sensitive SBCC interventions to safeguard communities against SSFFC malaria medicines and enhance treatment outcomes.
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Each year, WHO’s World malaria report provides a comprehensive and up-to-date assessment of trends in malaria control and elimination across the globe. This year’s report includes, for the first time, a dedicated chapter focused on the intersection between climate change and malaria. As describe...d in the report, climate change is one of many threats to the global response to malaria. Millions of people continue to miss out on the services they need to prevent, detect, and treat the disease. Conflict and humanitarian crises, resource constraints and biological challenges such as drug and insecticide resistance also continue to hamper progress.
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Malaria remains a significant public health concern, particularly in sub-Saharan Africa, where the majority of cases and fatalities occur, especially among children under five. Although there was a significant decline in global mortality and incidence between 2000 and 2015, progress has stalled sinc...e the late 2010s due to climate change, conflict, drug and insecticide resistance, and the ongoing effects of the pandemic. Economic modelling shows that achieving the Sustainable Development Goal target of reducing malaria incidence by 90% by 2030 could generate substantial economic benefits, including an increase in GDP of $142.7 billion in endemic countries and $80.7 billion in global trade gains. To save lives, strengthen health systems, and drive sustainable economic growth, renewed investments in malaria control and elimination programmes, vaccine deployment, and coordinated international support are essential.
Accessed on 25/08/2025.
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To support its R&D activities on Chagas disease, DNDi launched the Chagas Clinical Research Platform (CCRP). The platform brings together partners, experts, and stakeholders to provide support for evaluation and development of new treatments for Chagas disease. The patient-centred platform aims to f...acilitate clinical research, provide a forum for technical discussions, develop a critical mass of expertise, and strengthen institutional research capacities. In addition, it identifies and reviews priority needs, works towards standardization of methodology to assess drug efficacy and reviews alternatives for using current approved drugs (new schemes, doses, combination) and special scenarios (resistance).
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Report: A survey conducted among the 27 high MDR-TB burden countries.
March – July 2015
Stop TB Partnership in collaboration with Medecins Sans Frontieres (MSF).
Accessed November 2017.
The reports bring together the latest findings and conclusions about the state of resistance to artemisinins and artemisinin-based combination therapy (ACT), summarize WHO’s current policy and treatment recommendations, and highlight areas of concern.
Antimicrobial resistance (AMR) occurs when disease-causing pathogens are able to withstand the killing or suppressing power of antimicrobial medicines. This phenomenon increases the global burden of infectious diseases and strains health systems.This course aims to improve the learner's awareness an...d understanding of the basic principles of AMR, the impact AMR has on individuals and society, and why it is a major public health concern.
A complementary course, Antimicrobial Resistance (Part 2), describes interventions that address the multiple factors contributing to AMR across the health system.
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This training toolkit by the European Laboratory Initiative for TB, HIV and Viral Hepatitis provides a unique combination of practical guidance and expert advice on the interpretation of selected WHO-endorsed tests for drug-resistant tuberculosis (DR-TB).
WHO commissioned a survey, carried out in September/October 2015, among some 10 000 members of the public in 12 countries (2 per WHO Region: Barbados, China, Egypt, India, Indonesia, Mexico, Nigeria, the Russian Federation, Serbia, South Africa, Sudan and Viet Nam) on their use of antibiotics, knowl...edge of antibiotics and of antibiotic resistance. While not claiming to be exhaustive, this and other surveys will help WHO and partners to ensure efforts are focused on tackling some of the biggest gaps in understanding and the most prevalent misconceptions
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Frequently asked questions on Antimicrobial resistance.