title: Made in Europe: will artemisinin resistance emerge in French Guiana?
abstract: Resistance to artemisinin casts a shadow on the fight against malaria. The importance of illegal gold miners and of malaria in isolated regions of French Guiana constitutes a threat that endangers the fight against malaria in the Amazon. The hurdles of French laws and the remoteness of the territory from France make it impossible for the system to adapt to the problem of total inaccessibility of an important part of the malaria problem. Transmission is high in these areas and gold miners self-medicate with erratic regimens of artemisinin combinations, thus creating perfect conditions for the emergence of resistance. What needs to be done is being done, but within the limits of national law, with some results. However, facing the same difficult problem, Suriname shows more flexibility and is doing much better than French Guiana despite having lower resources. Local authorities in French Guiana cannot overrule the laws that block appropriate malaria care from reaching a third of malaria-exposed persons. Thus the health authorities in France should take immediate calibrated legislative and financial measures to avoid a predictable disaster.
authors: Centre d'Investigation Clinique Epidémiologie Clinique Antilles Guyane CIC-EC CIE 802, Cayenne General Hospital, Cayenne, French Guiana. mathieu.nacher66@gmail.com
authors: Mathieu
authors: M
authors: Nacher
authors: Philippe J
authors: PJ
authors: Guérin
authors: Magalie
authors: M
authors: Demar-Pierre
authors: Félix
authors: F
authors: Djossou
authors: François
authors: F
authors: Nosten
authors: Bernard
authors: B
authors: Carme
mesh_terms: D000962:Antimalarials / Q000494:pharmacology* / Q000627:therapeutic use*; D037621:Artemisinins / Q000494:pharmacology* / Q000627:therapeutic use*; D004351:Drug Resistance; D005060:Europe; D005616:French Guiana; D006291:Health Policy; D006801:Humans; D008288:Malaria / Q000188:drug therapy* / Q000469:parasitology*
chemical_list: D000962:Antimalarials; D037621:Artemisinins; C031327:artemisinin
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