A Potential Time Bomb of High Infection Rates and Drug Resistant Strains of Malaria
On April 25, the annual World Malaria Day, many health organizations will highlight important gains in fighting this deadly disease that claims more than one million lives every year. But despite notable progress in innovation and investment, MSF continues to see continuously high rates of malaria in several African countries. In the Democratic Republic of Congo (DRC), MSF has observed infection rates above emergency thresholds in several zones over the last six months, which can be largely attributed to a dysfunctional surveillance system, the failure of the health system to respond to elevated levels of malaria, poor organization, and lack of diagnostic testing and drugs.
DRC 2011 © Robin Meldrum
A mother and child in the pediatric ward of Niangara hospital.
"Artemisinin-resistant malaria parasites first emerged in Cambodia in 2006. Now researchers say the deadly bugs are quickly spreading.
Malaria remains one of the world’s great unnecessary killers. More than 650,000 people succumb to the disease each year — that’s more than one per minute — mostly in the poor nations of sub-Saharan Africa, but as deadly as malaria is, it doesn’t have to kill. Prevention and better treatment can stop the progression of the disease, and death tends to be a matter of extreme poverty.
Indeed, in recent years great progress has been made in controlling malaria, with deaths down 30% over the past decade. That’s thanks largely to more effective treatment regimens that make use of artemisinin, a plant-derived antimalarial drug originally developed in China. Artemisinin is the closest thing we have to a miracle drug for malaria.
That’s what makes the results of two studies out this week in the Lancet and Science so disturbing. Health officials have known for a while that some malaria parasites in the Southeast Asian nation of Cambodia have begun to develop resistance to artemisinin, but they hoped the resistance wasn’t spreading. Now researchers in the region have shown that artemisinin is becoming dramatically less potent in malaria cases in western Thailand, and they know it’s due to growing drug resistance in the malaria parasites themselves. If resistance to artemisinin were to spread to sub-Saharan Africa, the result could be a “public health disaster,” in the words of lead Lancet author Standwell Nkhoma of the Texas Biomedical Research Institute.
Artemisinin-resistant malaria parasites first emerged in Cambodia in 2006, which led to an international effort to control malaria and contain resistant strains there. But scientists in the Lancet study looked at more than 3,000 patients who were treated at malaria clinics in northwestern Thailand between 2001 and 2010. The researchers — including staff from Texas Biomed, Mahidol University in Bangkok and the Centre for Tropical Medicine at Oxford — found that it took longer and longer for malaria parasites to be cleared during treatment, a sign of growing resistance.”
Yellow = Current distribution of malaria
Red = Extended range distribution of malaria by 2050
Malaria is bad for humans, and becoming more and more resistant to vaccine.