Deadly disease: Malaria, which destroys red blood cells, claims 1 million lives in Africa each year.

A new antimalarial drug, the product of a public-private partnership initiated by UK researchers, will soon hit the market in African countries. The drug, dubbed lapdap, was approved by the UK's Medicines and Healthcare Products Regulatory Agency in August and will be available this fall in sub-Saharan Africa.

“I think there is a lot of promise in [lapdap] and I think it's going to be a stronger drug than Fansidar,” says Thomas Wellems, head of the malaria genetics section at the US National Institutes of Health.

Fansidar has been the drug of choice for public health systems in Africa since chloroquine resistance began to spike more than 10 years ago. In some regions, however, clinical failure rates for Fansidar are as high as 25%, and the alternatives are relatively expensive and out of reach for many Africans. Lapdap targets the same pathway in the Plasmodium falciparum parasite as Fansidar, but it clears much faster from the body, so there is less opportunity for the parasite to develop resistance.

As part of the partnership, GlaxoSmithKline agreed to public-sector price controls that would keep the drug about as cheap as Fansidar. William Watkins, a researcher at the University of Liverpool, and his colleagues had that in mind in the mid-1990s when they initiated the partnership, which also includes the Tropical Disease Research Programme of the World Health Organization (WHO/TDR) and the UK government (Nat. Med. 7, 389; 2001).

Because Fansidar resistance rose rapidly, however, WHO/TDR is wary of widespread use of lapdap in the public sector, and no African government has yet signed up to buy it, says Watkins. According to Allan Schapira, WHO's coordinator for the Roll Back Malaria initiative, the agency's policy is to minimize the risk of resistance by promoting the use of combination therapies, such as lapdap with artesunate. The combination is currently being tested in phase 2 clinical trials.

A number of other antimalarial drugs in the pipeline are products of public-private partnerships, including the Medicines for Malaria Venture. Many of those new drugs are also to be used in combination with artesunate or related compounds. Some researchers are working on synthetic compounds that could cheaply substitute for artesunate, and others are developing drugs that target a variety of pathways, including the one used by chloroquine.