For acute uncomplicated infections caused by Plasmodium falciparum, treatment is aimed at the rapid and complete elimination of the parasite from the blood stream to prevent progression to severe and potentially fatal disease. The artemisinin containing therapies (ACTs), of which there are five, are recommended by WHO as first-line treatment. By 2014, they had been adopted in 81 countries with 337 million treatment courses being delivered to both the public and private sectors.
In 2015, artemisinin resistance had been confirmed in five countries of the Greater Mekong sub-region - Cambodia, Laos, Vietnam, Thailand and Myanmar. In the absence of alternative treatments and pending the development of non-artemisinin-based containing therapies, of which the combination of fosmidomycin and piperaquine is a front runner, reliance is being placed on prolonged courses of ACTs of up to 10 days duration to effect radical cures.