Viruses Treatment Articles

Drug-Resistant Malaria Parasite Spread Must Be Stopped

November 07, 2017

If drug-resistant malaria parasite spread and development is not halted, there is a serious risk of significantly undermining the efficacy of current treatments for the disease, researchers reveal in an article published by the World Health Organization (WHO) and the Roll Back Malaria (RBM) partnership. Current artemisinin-based combination therapies are our most powerful weapons in treating falciparum malaria.

Plsamodium falciparum (P. falciparum), also known as falciparum malaria is the most serious and fatal form of the disease. It is most commonly found in sub-Saharan Africa. According to current data, there are reported cases of this type of malaria in parts of the world where it was supposed to have been eradicated.

The article, "Global Plan for artemisinin resistance containment", explains what needs to be done to contain and prevent artemisinin resistance. Artemisinins are key for ACTs (artemisinin-based combination therapies).

The authors write that a growing number of cases of resistance to artemisinins have been reported on the Cambodian-Thai border. ACTs are 90% effective worldwide; however, prompt action is urgently required to stem the spread of resistance. Otherwise, affected countries will be left with no effective medications.

Dr Margaret Chan, WHO Director-General, said:

"The usefulness of our most potent weapon in treating malaria is now under threat. The new plan takes advantage of an unprecedented opportunity in the history of malaria control: to stop the emergence of drug resistance at its source and prevent further international spread.

The consequences of widespread artemisinin resistance compel us to seize this opportunity."

A five-step action plan has been put forward to stem the spread of artemisinin resistance: Halt the resistant-parasite spread - The Global Malaria Action Plan outlines a fully-funded malaria control strategy which should address the spread and development of artemisinin resistance. Nevertheless, further funding will be required to make sure the resistant parasite does not make headway in areas where it has emerged. An addition, $10 to $20 per person will be required in the Cambodia-Thailand border, as well as $8 to $10 per person in the Greater Mekong area, deemed to be "at risk". Better monitoring and surveillance for artemisinin resistance - Of the 75 countries that should have been carrying out routine testing of the efficacy of ACTs in 2010, only 31 did so, according to WHO. If the number of countries is not increased considerably there is a serious risk that the resistant parasite spreads and develops surreptitiously. More accurate diagnosis of malaria - ACTs are often misused for treating non-malaria fever. Using ACTs for patients without malaria contributes to resistance risk. WHO says all suspected malaria patients should undergo diagnostic testing before treatment is administered. This means access to malaria diagnostic testing must be improved. More research into detecting resistant parasites - We need to develop faster techniques for detecting resistant parasites. New medications which can eventually replace ACTs should also be researched more thoroughly. In order to do this, more investment into research should become a top priority. Motivate action and mobilize resources - Only with a well-coordinated and properly funded response from several stakeholders at national, regional and global levels, will the global plan have any chance of success. Professor Awa Coll-Seck, Executive Director of the Roll Back Malaria Partnership, said:

''Effective containment of artemisinin resistance will significantly improve our capability to sustain current control achievements at country level. We now have a coordinated plan to stop the spread of resistant parasites, but we need additional funding to fully implement it."

Over the past ten years the numbers of malaria cases are estimated to have dropped by over 50% in 43 nations, according to WHO. Over 730,000 lives have been saved over the last decade in 34 African countries, the majority of them since 2006, when ACT use as well as the distribution of insecticide-treated mosquito nets became more widespread, according to a WHO modeling analysis of malaria prevention.

If ACTs lose their effectiveness, WHO fears that the number of malaria-related fatalities would increase considerably.

Dr Robert Newman, Director of the WHO Global Malaria Program, said:

"We have made tremendous progress over the past decade in the fight against malaria. If we are to sustain these gains and achieve the health-related Millennium Development Goals, then it is essential that we work together to overcome the threat of artemisinin resistance."

The Global Plan for Artemisinin Resistant Containment was funded by the Bill & Melinda Gates Foundation and developed by the WHO Global Malaria Program. Over 100 malaria experts from across the Roll Back Malaria Partnership were consulted.

"Global Plan for Artemisinin Resistant Containment" (PDF - 87 Pages - 2.15MB)
World Health Organization, Roll Back Malaria