Containing artemisinin resistance

TropIKA

2 Mar 2009
Paul Chinnock
Source: World Health Organization (see original article)

A technician of the Government Pharmaceutical Organization in Thailand works on the production of antimalarials containing artemisinin, but resistance to the drug has been reported along the Thai-Cambodia border. WHO/TDR/Crump.

The World Health Organization will receive a $22.5 million grant from the Bill & Melinda Gates Foundation which will be devoted to finding ways to hold back the spread of resistance to the key antimalarial drug artemisinin.

The drug has become the mainstay of the recommended treatment for malaria, older treatments now being ineffective. Appropriate treatment with artemisinin-based combination therapies (ACTs) succeeds in more than 90% of cases. However, surveillance systems and research studies supported have provided evidence that parasites resistant to artemisinin have recently emerged along the border between Cambodia and Thailand. This could seriously undermine the success of global malaria control efforts.

“If we do not put a stop to the drug-resistant malaria situation that has been documented in the Thai-Cambodia border, it could spread rapidly to neighbouring countries and threaten our efforts to control this deadly disease,” said Dr Hiroki Nakatani, Assistant Director-General of WHO.

“We know that malaria can be treated and prevented,” said Dr Regina Rabinovich, Director of Infectious Diseases Development at the Bill & Melinda Gates Foundation, “and if we lose the key treatment available at this time, it’s like living in a house with a half a roof.”

WHO says it will use the Gates grant to meet the following key objectives:

- eliminate artemisinin-tolerant parasites by detecting all malaria cases in target areas and ensuring effective treatment

- reduce exposure of the parasites to artemisinin to limit emergence of resistance

- prevent transmission of artemisinin-tolerant malaria parasites through mosquito control and personal protection

- limit the spread of artemisinin-tolerant malaria parasites by mobile populations;

- support the containment and elimination of artemisinin-tolerant parasites through comprehensive behaviour change, communication, community mobilization and advocacy

- undertake basic and operational research to fill knowledge gaps and ensure that strategies applied are evidence-based

- provide effective management, surveillance and coordination to enable a rapid and high-quality implementation of the strategy.

WHO says it will work in collaboration with several partners including the National Center for Parasitology, Entomology and Malaria Control of the Cambodian Ministry of Health, Bureau of Vector-Borne Disease of the Thai Ministry of Public Health, Faculty of Tropical Medicine of Mahidol University Bangkok, Institut Pasteur Cambodia, Mahidol Oxford Tropical Medicine Research Unit, Bangkok and the Malaria Consortium.