Made in Europe: will artemisinin resistance emerge in French Guiana?

Resistance to artemisinin casts a shadow on the fight against malaria. Theimportance of illegal gold miners and of malaria in isolated regions of FrenchGuiana constitutes a threat that endangers the fight against malaria in theAmazon. The hurdles of French laws and the remoteness of the territory fromFrance make it impossible for the system to adapt to the problem of totalinaccessibility of an important part of the malaria problem. Transmission ishigh in these areas and gold miners self-medicate with erratic regimens ofartemisinin combinations, thus creating perfect conditions for the emergence ofresistance. What needs to be done is being done, but within the limits ofnational law, with some results. However, facing the same difficult problem,Suriname shows more flexibility and is doing much better than French Guianadespite having lower resources. Local authorities in French Guiana cannotoverrule the laws that block appropriate malaria care from reaching a third ofmalaria-exposed persons. Thus the health authorities in France should takeimmediate calibrated legislative and financial measures to avoid a predictabledisaster.