Drug-resistant malaria could spread fast, expert warns

[Guest guest]

WHO Urges Action to Prevent Resistance to Anti-Malarial Drug.

" The usefulness of these therapies is now under threat… over the past several

decades, we have lost one front-line medicine after another as resistance has

developed, become established, and then rapidly spread internationally, making

all these drugs useless, " said Chan. " And this is no exaggeration for me to say

that the consequences of wide-spread resistance to artemisinins would be

catastrophic. "

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e-to-Anti-Malarial-Drug-113362419.html

Drug-resistant malaria could spread fast, expert warns

By Nebehay Jan 12, 2011 12:57pm EST

GENEVA (Reuters) - Drug-resistant malaria could spread from southeast Asia to

Africa within months, putting millions of children's lives at risk, a leading

expert warned on Wednesday.

White, professor of tropical medicine at Mahidol University in Bangkok,

called for a war before it is too late on the malaria strain resistant to the

drug artemisinin that first emerged along the Thai-Cambodian border in 2007.

This longer-to-treat form of malaria is suspected of breaking out along the

Thai-Myanmar frontier and in a province of Vietnam, where tests are under way to

confirm it, but the great fear is of it reaching Africa.

" It is a time bomb, it is ticking. It has the potential of killing millions of

African children, " White told Reuters.

A migrant worker who doesn't even show symptoms could spread the resistant

parasite beyond Asia, he said. " It could be a Chinese worker acting as an

adviser in Cambodian forests who then hops on a plane to Africa. It could go off

at any minute. "

Earlier, the World Health Organization (WHO) launched a $175 million annual plan

to contain and prevent the global spread of the artemisinin-resistant parasite

beyond the Mekong region.

The WHO, which said last month the world could stop malaria deaths by 2015 with

massive investment, called for faster research and development of new

anti-malarial drugs.

FIGHTING THE WAR

But White, widely credited with helping to first identify the resistant form,

called the WHO plan " somewhat anodyne. "

" I think we should fight this as a war. We are too fractured as a community, " he

told an experts meeting at WHO headquarters.

" What seems to be lacking is a sense of urgency. People talk in terms of years.

I think we should be thinking in terms of months. Time is crucial, " he 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-general

Margaret Chan said in a speech. " The consequences of widespread resistance to

artemisinins would be catastrophic. "

Resistance to previous generations of anti-malarial drugs such as chloroquine

spread from the same Mekong region to India and then Africa, killing millions,

experts say.

" This part of the world is the historical epicenter for the emergence of

drug-resistant malaria parasites. History tells us what to expect, " Chan said.

White agreed, telling Reuters: " There is a horrible, chilling parallel. It is

not as if we haven't been warned. "

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, a WHO report said.

Some 5 million compounds are being screened as potential anti-malarials, 20,000

of which show promise, according to Dr. Reddy, the new CEO of the

Medicines for Malaria Venture, a public-private drugs partnership.

" That is how wide we have to cast the net in order to get a handful of drugs

that will be tomorrow's medicines, " 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 a year, it

said.

http://www.reuters.com/article/idUSTRE70B2XO20110112