and asymptomatic malaria has been underestimated substantially.Counterfeit and substandard drugs are a major threat to malaria control, and more active counter measures,stronger legislation, and better surveillance are needed.
Artemisinin resistance poses the greatest threat to global malaria control, and more vigorous containment
and elimination measures than have been instituted in the past 6 years are needed. Radical measures to eliminate resistance foci, such as mass drug administration,might be needed. The value of active case detection is uncertain. Greater use of primaquine to prevent relapse of vivax malaria and as a gametocytocide in falciparum malaria would help with control and elimination in areas with low transmission