Drug resistant malaria on the prowl

By Dr. Ananya Mandal, MDJan 12 2011

Experts have warned that drug-resistant malaria could spread from Southeast Asia to Africa within months, putting millions of children’s lives at risk. Nicholas White, professor of tropical medicine at Mahidol University in Bangkok warned that a malaria strain resistant to the drug artemisinin that first emerged along the Thai-Cambodian border in 2007. This longer-to-treat form of malaria is suspected of breaking out along the Thai-Myanmar frontier and in a province of Vietnam, where tests are under way to confirm it, but biggest fear is of it reaching Africa. White said, “It is a time bomb, it is ticking. It has the potential of killing millions of African children.” He explained that it could be carried by a migrant worker. “It could be a Chinese worker acting as an adviser in Cambodian forests who then hops on a plane to Africa. It could go off at any minute,” he said.

Earlier, the World Health Organization (WHO) launched a $175 million annual plan to contain and prevent the global spread of the artemisinin-resistant parasite beyond the Mekong region. It was only last month that the WHO had said that the world could stop malaria deaths by 2015 with massive investment, called for faster research and development of new anti-malarial drugs.

The five-step Global Plan for Artemisinin Resistance Containment aims to contain and prevent artemisinin resistance by

• Stopping the spread of resistant parasites
• Increase monitoring and surveillance for artemisinin resistance
• Improve access to malaria diagnostic testing & rational treatment with ACTs
• Invest in artemisinin resistance-related research &
• Motivate action and mobilize resources.

Artemisinin, derived from sweet wormwood, or the Artemisia annua plant, is the most potent drug available against malaria, especially when used in artemisinin combination therapy (ACT), which links it with other drugs. WHO director-general Margaret Chan said in a speech, “ACTs are the gold standard. They are the most effective treatment for falciparum malaria, the most deadly form of malaria… The consequences of widespread resistance to artemisinins would be catastrophic.” Malaria infects about 243 million people worldwide a year, causing an estimated 863,000 deaths, making it a major killer especially among African children.

According to Dr. David Reddy, the new CEO of the Medicines for Malaria Venture, a public-private drugs partnership, some 5 million compounds are being screened as potential anti-malarials, 20,000 of which show promise. “That is how wide we have to cast the net in order to get a handful of drugs that will be tomorrow’s medicines.”