THE RISE AND FALL OF MEFLOQUINE AS AN ANTIMALARIAL DRUG IN SOUTH EAST-ASIA

Mefloquine is an antimalarial drug developed by the U.S. Army Antimala rial Drug Program in conjunction with the World Health Organization an d Hoffmann-La Roche to address the problem of chloroquine-resistant fa lciparum malaria encountered during the Vietnam War. Despite the expen diture of millions of dollars over a 20-year period, it is unlikely th at mefloquine will ever be used for U.S. soldiers deployed to South Ea st Asia. Although mefloquine met the specifications set by its develop ers, its usefulness is now limited by the rapid evolution of drug resi stance following its release to the civilian population. Drug developm ent for particular military needs was compromised by a rapid biologica l response from the parasite and military concerns. In an era of shrin king military budgets, military drug development programs will by nece ssity be more resource constrained, thus yielding fewer new drugs per decade. In the short term, emphasis should be directed toward adapting available antimicrobial drugs for antimalarial purposes.