Categories: Health

Urgent action needed as malaria evolves resistance to key drug

A similar story has happened before. The parasite became resistant to a previous drug – chloroquine – in East Africa in the 1970s, and resistance reached the west coast by the 1980s.

Malaria deaths on the continent trebled from about 493,000 in 1980 to 1.6 million by 2004.

“I’m hoping this is not something we will see in Africa,” Dr Dhorda told me.

“If artemisinin combination therapy starts failing, then cases and deaths will go up.”

The authors have made a series of recommendations targeting both the parasite and the mosquitoes that spread the disease.

They suggest adding a third drug to the artemisinin combination therapy to make it harder for the parasite to evolve resistance to therapy.

Dr Dhorda says this will cost money but: “We might spend a little more now, but if not we’ll be spending a lot more to control the fire rather than putting it out before it became widespread.”

They also call for:

Expanded coverage of insecticide-treated bed nets and long-acting insecticides that are sprayed in people’s homes
Target the newly developed malaria vaccines to people of all ages (rather than just children) in areas with artemisinin-resistant malaria
Supporting community health workers, so treatment is available close to everyone’s home
Ensuring data on the spread of resistant strains is shared rapidly, because at the moment there can be long delays

“We ask funders, specifically the Global Fund to Fight Aids, Tuberculosis and Malaria and the US government’s President’s Malaria Initiative, to be visionary and to step up funding for malaria control and elimination programmes to contain the spread of artemisinin resistance in Africa,” said Ntuli Kapologwe, director of preventive services at the Ministry of Health in Tanzania.

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