Schistosomiasis is a debilitating neglected tropical disease caused by schistosome worms. Global efforts to control schistosomiasis rely predominantly on mass drug administration of the drug praziquantel to populations at risk of infection. We review the history of schistosome drug development and the current position of schistosome drug research. We conclude that with no additional candidates currently in the anti-schistosome drug clinical trial pipeline, a practical and necessary approach is to optimise the health benefits from praziquantel. We offer suggestions of where and how this can be achieved. We also highlight knowledge gaps in the utility of praziquantel particularly in the treatment of chronic schistosomiasis, which includes fibrosis, organomegaly and cervical lesions associated with female genital schistosomiasis.
Keywords: Schistosoma; antimony potassium tartrate; artesunate; metrifonate; mirazid; oxamniquine; pediatric formulation; praziquantel; schistosomiasis; therapeutics.