About the compendium

Advancing molecular surveillance of antimalarial drug resistance

Global efforts to harness genetic information for monitoring and responding to antimalarial drug resistance have been limited by fragmented data collection and the absence of validated resistance markers for several key medicines. The first version of the "Compendium of molecular markers for antimalarial drug resistance" seeks to address this gap by synthesizing current evidence on the association between specific genetic alterations and parasite susceptibility to antimalarial drugs recommended by WHO for the treatment of blood-stage malaria parasites.

What the compendium offers

This compendium provides: 

  • A systematic presentation of resistance-associated genetic alterations by individual antimalarial drugs 
  • An evidence-based classification of molecular markers of antimalarial drug resistance identified to date
  • A reference to support coordinated molecular surveillance and targeted research at national, regional, and global levels 

The compendium is intended to be updated annually, incorporating new evidence on molecular markers and where relevant, updates to the methodologies used for their classification. 

Expert-guided development process

The compendium is the result of a multistep process involving: 

  • Development of criteria and thresholds for evidence evaluation 
  • A literature review of published laboratory, clinical, and genetic epidemiology studies on molecular markers of antimalarial drug resistance 
  • Two rounds of expert consultations to refine and validate the classification of molecular markers  

Each marker was initially assessed by primary reviewers using predefined thresholds and literature reviews. Additional experts reviewed the initial assessment of the evidence and categorization of markers.  

Acknowledgements 

The development of this compendium was guided by an international group of experts. Their contributions were critical in setting the methodology for reviewing evidence, refining marker classifications, and ensuring scientific rigor. WHO acknowledges the valuable input of all primary and secondary reviewers, as well as the broader community of researchers and national malaria programme representatives who contributed data and expertise.