title: Can pharmacogenomics improve malaria drug policy?
abstract: Coordinated global efforts to prevent and control malaria have been a tour-de-force for public health, but success appears to have reached a plateau in many parts of the world. While this is a multifaceted problem, policy strategies have largely ignored genetic variations in humans as a factor that influences both selection and dosing of antimalarial drugs. This includes attempts to decrease toxicity, increase effectiveness and reduce the development of drug resistance, thereby lowering health care costs. We review the potential hurdles to developing and implementing pharmacogenetic-guided policies at a national or regional scale for the treatment of uncomplicated falciparum malaria. We also consider current knowledge on some component drugs of artemisinin combination therapies and ways to increase our understanding of host genetics, with the goal of guiding policy decisions for drug selection.
authors.affiliation: Institute of Pharmacogenomics and Individualized Therapy, Eshelman School of Pharmacy, University of North Carolina, 120 Mason Farm Road, Chapel Hill, NC 27599-7361, United States of America. mroederer@unc.edu
authors.forename: Mary W
authors.initials: MW
authors.lastname: Roederer
authors.forename: Howard
authors.initials: H
authors.lastname: McLeod
authors.forename: Jonathan J
authors.initials: JJ
authors.lastname: Juliano
mesh_terms: D000349:Africa; D000962:Antimalarials / Q000627:therapeutic use*; D003657:Decision Making; D004359:Drug Therapy, Combination; D014644:Genetic Variation; D014943:Global Health; D006291:Health Policy; D006293:Health Promotion / Q000379:methods* / Q000592:standards; D006801:Humans; D016778:Malaria, Falciparum / Q000188:drug therapy* / Q000235:genetics / Q000517:prevention & control; D010597:Pharmacogenetics / Q000379:methods*; D010602:Pharmacopoeias as Topic / Q000592:standards*; D016730:Program Development / Q000379:methods; D011634:Public Health; D040241:Social Marketing
chemical_list: D000962:Antimalarials
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