WHO global plan to contain drug-resistant malaria

The World Health Organisation launched a plan on Wednesday to stop a form of drug-resistant malaria from spreading from Southeast Asia to Africa, where millions of lives could be at risk.

It would cost about $175-million a year to contain and prevent the global spread of the artemisinin-resistant parasite which first emerged along the Thai-Cambodian border in 2007, the United Nations agency said.

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.

“ACTs are the gold standard. They are the most effective treatment for falciparum malaria, the most deadly form of malaria,” WHO director-aeneral Margaret Chan told an experts’ meeting. “It is no exaggeration to say that the consequences of widespread resistance to artemisinins would be catastrophic.”

The resistant and therefore longer-to-treat form of malaria is suspected of breaking out along the Thai-Myanmar border and in a province of Vietnam, where tests are underway to confirm it, but the great fear is of it breaking out across Africa.

“There is a finite window of opportunity to contain artemisinin resistance before it spreads,” the WHO warned in a report, “Global Plan for Artemisinin Resistance Containment”.

Historical epicentre
Resistance to previous generations of anti-malarial drugs spread rapidly from the same Mekong region to India and then Africa, resulting in many deaths, according to the WHO strategy, drawn up by 100 global experts.

“This part of the world is the historical epicentre for the emergence of drug-resistant malaria parasites. History tells us what to expect,” Chan said.

Malaria infects about 243-million people worldwide a year, causing an estimated 863 000 deaths, making it a major killer especially among African children.

Yet few promising alternatives are available in the immediate research and development pipeline, the report said.

The $175-million being sought for containment would include some $65-million for accelerating research and development of new antimalarial drugs which are not based on artemisinin. Overall, some $3-billion is spent annually on malaria control.

The rest of the funds would be used to better track the disease and buy diagnostic kits to detect the resistant form.

Dr David Brandling-Bennett, deputy director for malaria at the Bill and Melinda Gates Foundation, said fighting malaria was a priority and artemisinin resistance was a “red alert”.

It was critical for researchers to identify a molecular genetic marker for resistance, which would help screen populations at risk, he said.

“We are still trying to do this, I hope we will succeed. But I do have concerns that we are not yet collaborating enough in research, so we encourage partners to share parasites,” he said.

Swiss drugmaker Novartis and Sanofi-Aventis of France make the most widely-used ACTs, which treat 80-million and 45-million patients respectively per year, according to the Geneva-based Medicines for Malaria Venture. — Reuters

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