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Table 3 Priorities – attacking artemisinin resistance

From: CRIMALDDI: a prioritized research agenda to expedite the discovery of new anti-malarial drugs

Important quick wins • Establish a clear definition of artemisinin “resistance”, stemming from a clinical observation of increased treatment failure and parasite clearance times. Include a broad profile of how resistance manifests itself, such as the window of parasite killing across the 48-hr erythrocytic cycle and correlation of PCT with the experimental in vitro parameters
• Greatly improve access to resistant parasites in order to broaden as far as possible groups able to work on resistance
Removing key roadblocks to future progress • Define the molecular and cellular basis of artemisinin-induced dormancy and develop easier to measure markers of dormancy and/or reduced susceptibility
• Identify discriminatory phenotypes by systematic re‒evaluation all of the in vitro assays available
Speeding-up drug discovery • Establish stable resistant parasite lines to improve access and broaden number of groups able to study resistance mechanisms
  • Identify and evaluate an appropriate range of “omic” approaches to search for discriminatory tools and markers of artemisinin resistance