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January 11, 2011

WHO Urges Action to Prevent Resistance to Anti-Malarial Drug

by Lisa Schlein

The World Health Organization is calling for urgent action to prevent the spread of resistance to artemisinin-based combination therapies, the most effective treatments for malaria. WHO is launching a new action plan to protect what it calls the most potent weapon in treating this deadly disease.

The discovery of resistance to artemisinins along the Cambodia-Thailand border in 2008 set off the alarm bells. This is because these medicines are the most effective treatment for falciparum malaria, the most deadly form of the disease.

Director-General of the World Health Organization, Margaret Chan, said artemisinin, in combination with another anti-malarial drugs, increases the likelihood of killing the malaria parasites.

“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.”  

WHO notes tremendous progress has been made over the past decade in the fight against malaria. It estimates the number of malaria cases has fallen by more than half in more than 43 countries.   

A recent analysis in 34 African countries finds more than 730,000 lives have been saved between 2000 and 2010, nearly three quarters of them since 2006. This is when the use of insecticide-treated mosquito nets and artemesinin-combination therapies became more widespread.

Public health officials say many lives will be lost if the emergence of artemisinin resistance is not stopped dead in its tracks.  

Coordinator for the WHO Global Malaria Program, Dr. Pascal Ringwald, said that WHO’s five-step global action plan aims to do just that. “What we try to do is to try to stop the spread of resistance… using better treatment, doing a lot of vector control and education of the population. We must also increase the monitoring of anti-malaria drug efficacity. This means that we have to see if the drug is still effective and if artemesinin (resistance) is not emerging in any other places.”  

Ringwald said it is important to improve diagnostic testing to make sure people are being treated for malaria and not for fever arising from other causes. He said new anti-malarial medicines must be developed to eventually replace the artemisinins.

And finally, Ringwald said the success of the global plan will depend on getting the money needed to implement its measures. That amount comes to $175 million a year.