Global Malaria Programme
The WHO Global Malaria Programme (GMP) is responsible for coordinating WHO's global efforts to control and eliminate malaria. Its work is guided by the "Global technical strategy for malaria 2016–2030" adopted by the World Health Assembly in May 2015 and updated in 2025.
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Global database on antimalarial drug efficacy and resistance

The global database on antimalarial drug efficacy and resistance was initiated in 2000 to centralize data and facilitate reporting on the status of antimalarial drug efficacy in malaria endemic countries. 

The contents of the database are extracted from published and non-published reports of therapeutic efficacy studies (TES) and surveys of molecular markers on antimalarial drug resistance conducted by ministries of health, national malaria programmes, research institutes and nongovernmental organizations.

Therapeutic efficacy study data

The database includes data on TES conducted in accordance with the WHO standard protocol for monitoring antimalarial drug efficacy. Since study duration often extends over 2 calendar years, the year in the database refers to the year in which the study began. Studies have a minimum follow-up period of 28 days, with polymerase chain reaction (PCR)-correction to distinguish between treatment failures caused by reinfection from those caused by recrudescence. 

Treatment failure rates are calculated using the per-protocol method. This analysis includes only patients who complete the entire study follow-up and have a clear outcome of either treatment success or failure. Patients who do not complete follow-up, deviate from the study protocol, or withdraw are excluded from the analysis. Treatment failure rates using the Kaplan-Meier analysis are provided when available. 

A summary of treatment failure rates by treatment and country is available on the dashboards of the Malaria Threats Map.

Molecular markers of antimalarial drug resistance data

The database also includes data on the geographical distribution of molecular markers associated with P. falciparum drug resistance, including: 

  • PfKelch13 (artemisinin resistance)
  • Pfplasmepsin 2-3 copy number (piperaquine resistance) 
  • Pfmdr1 copy number (mefloquine resistance)
  • Pfcrt in Mesoamerica (chloroquine resistance)

Collection of information on planned and ongoing monitoring of drug efficacy and resistance

Regular monitoring of antimalarial drug efficacy is needed to inform treatment policies, and surveillance of molecular markers of antimalarial drug resistance can help track the spread of antimalarial drug resistance and inform the need for further activities. Having an overview of planned and ongoing collection of efficacy and resistance information is crucial to direct resources and surveillance activities.

WHO has therefore developed 2 dashboards: one to collect information on studies of drug efficacy and another to collect information on surveys of molecular markers of drug resistance. These dashboards are to be voluntarily populated by representatives of ministries of health, partners and research groups leading surveillance efforts. Collectively this will generate a global picture of drug efficacy and resistance surveillance efforts.

The contents of the dashboard will be updated monthly and freely downloadable and eventually visually integrated into the Malaria Threats Map platform.  

 

Information products based on the global database

  • The report on antimalarial drug efficacy, resistance and response provides a comprehensive overview of drug efficacy and the resistance of malaria parasites to antimalarial medicines. 
  • The Malaria Threats Map provides a visual overview of the status of antimalarial drug efficacy, with results from TES and molecular marker studies of drug resistance in malaria endemic countries.