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Is sulphadoxine-pyrimethamine (SP) still useful as the first-line antimalarial drug in Malawi or it must be quickly withdrawn from the antimalarial repertoire? Nkhoma, Standwell Abstract In recent years our efforts to control malaria successfully have been severely hampered by widespread and highlevel resistance to front-line antimalarial drugs. In 1993,Malawi had to replace chloroquine (CQ) with sulphadoxinepyrimethamine (SP) as the first-line antimalarial owing to unacceptably high rates of CQ failure. Thirteen years after this change in treatment policy, Malawi is faced with a scenario that calls for yet another switch to a different first-line antimalarial. Keywords antimalarial

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