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Malaria: A race against resistance

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Several African nations could strike a major blow against malaria by sacrificing the efficacy of some older drugs. Can they make it work?

It is September in southeastern Mali, and Louka Coulibaly is standing in the shade of a squat, concrete building, giving instructions to a dozen men and women perched on a wobbly wooden bench. Coulibaly, a local medical supervisor, hands out nylon backpacks, each filled with bags of pills, plastic cups and a porcelain mortar and pestle that the women pause to admire. By noon, the men and women are packing up and heading back to their respective villages on foot, bicycle and motorcycle.

The following day, they and about 1,400 other health workers throughout the region will set up shop in public spaces: under the shade of mango trees, in one-room schools, at market stands and in district health centres. They will mix and mash the pills with the mortar and pestle, dissolve them in water in a cup, and hand the bitter dandelion-coloured liquid to about 164,000 children.

The effort is part of a broad campaign to prevent malaria by providing African children with drugs usually used to treat the disease. Nearly 1.2 million healthy children from parts of Mali, Togo, Chad, Niger, Nigeria and Senegal received these drugs during the rainy season — from around July to November — when malaria usually ravages the population.

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