According to the WHO, there are an estimated 216 million new cases of malaria every year. With the growing number of cases reported to be resistant to antimalarial drugs, new strategies are crucial when it comes to reducing the number of deaths caused by the disease.
In order to combat this widespread drug resistance, a team of researchers have introduced a radical new programme, with the goal of eliminating malaria in south east Asia. The programme involves giving antimalarial drugs to entire populations in high risk areas, regardless of whether they are showing symptoms or not. In a trial, the team gave drugs to 365,000 people in Myanmar, who were living in malaria “hotspots”.
They set up 1200 clinics in east Myanmar, ensuring that someone was in each area to diagnose and treat new cases. Individuals living in these areas were then given three rounds of antimalarial drugs, a month apart. They were given to everyone except infants under six months, pregnant women and those with and allergy to the drug.
No side effects were reported, and the team found that by targeting entire populations, they were able to drastically reduce the number of malaria cases. In some cases, it was eliminated altogether. It was also found that the incidence of P. falciparum malaria, which causes the most infections and deaths in this particular region, fell from 25 per 1000 people per month to just 5 per 1000.
Oxford University’s Prof François Nosten, who is also director of the Shoklo Malaria Research Unit in Mae Sot, Thailand said: “There has been no clear containment strategy so, despite substantial international investment in regional malaria control, drug-resistant malaria now extends across the whole of the Greater Mekong sub-region.”
He added: “However this study provides hard evidence that it is possible to eliminate artemisinin-resistant falciparum malaria rapidly if the will and the financial support are forthcoming. We are losing a dangerous race to eliminate falciparum malaria before drug resistance spreads beyond South-East Asia and into Africa – and this study shows us how to do it.”
It’s hoped that this study will provide a much needed solution to the ongoing problem of antimalarial drug resistance. Artemisinin compounds, which are considered to be the best drugs in fighting malaria, have become resistant throughout southeast Asia, and it’s feared that this resistance will spread to other parts of the world like India and Africa. The researchers are calling for the WHO to back this new initiative so it can be extended to other areas.
Professor Sir Nick White, chair of the Mahidol Oxford Tropical Medicine Research Unit which ran the study and board member of the Worldwide Antimalarial Resistance Network (Warn) said: “It is hard. People don’t want to move outside their comfort zone of the current approaches. We need very high level political commitment and the money. We think the risk to the rest of the world is significant and we can’t afford to let this get out of control. If it extends to India and Africa that’s it. All the gains could be reversed.”