Introduction
The treatment of malaria has improved substantially in the past 15 years, and morbidity and mortality have declined as a result, but significant challenges lie ahead (1). The major advance in antimalarial therapeutics has been the deployment of drugs derived from artemisinin (qinghaosu) (2). This unusual compound (a sesquiterpene lactone peroxide) is derived from the leaves of the plant Artemesia annua. The derivatives of artemisinin; dihydroartemisinin (DHA), artesunate and artemether now form the cornerstone of current antimalarial treatment. They are the most rapidly acting of available antimalarial drugs and they are very well tolerated, but resistance has now emerged in Southeast Asia and it has spread, and there are worrying early reports from other regions. These drugs are partnered in fixed-dose combinations (artemisinin combination therapies) with more slowly eliminated antimalarial drugs for the treatment of uncomplicated malaria. New antimalarial drugs are on the horizon, but they are unlikely to become generally available within the next few years, so current treatments must rely upon the artemisinin derivatives. This review presents some of the recent advances in antimalarial therapeutics and some of the obstacles to progress in controlling and eliminating malaria.