Africa is facing a public health disaster in the form of multi-drug resistant malaria. People infected with malaria in eastern, central and southern Africa are rapidly becoming resistant to one of the most affordable and commonly used anti-malaria drugs, sulphadoxine-pyrimethamine (SP). Previously, a number of safe and cheap drugs including SP have kept down the number of deaths and people suffering from severe ill health caused by malaria. But there are ominous predictions that disaster looms - unless governments are willing to reconsider their treatment regime.