Drug-resistant malaria threatens to spread from Burma, say researchers
Malaria with total resistance to the
antimalarial drug artemisinin has taken
hold in Burma and spread close to the
border with India, threatening to render
crucial medicines useless, scientists have
warned.
If the resistant parasite reached India it
would pose a serious threat to the chances
of global control and eradication of the
killer mosquito-borne disease, said
Charles Woodrow of the Mahidol-Oxford
tropical medicine research unit.
And if resistance spread from Asia to
Africa, or emerges in Africa independently
– as has been seen before with previously
effective but now powerless antimalarials
– “millions of lives will be at risk”, they
said in a report.
“[Burma] is considered the front line in the
battle against artemisinin resistance as it
forms a gateway for resistance to spread to
the rest of the world,” said Woodrow, who
led the Oxford study.
In a study published in the Lancet
Infectious Diseases journal, Woodrow’s
team collected 940 parasite samples at 55
malaria treatment centres across Burma
and its border regions. They found that
almost 40% of the samples had mutations
signalling artemisinin resistance.
They also confirmed resistant parasites in
Homalin, in the Sagaing region, 15 miles
(25km) from the Indian border.
While there have been significant
reductions in malaria infection it still kills
around 600,000 people a year – most of
them children in the poorest parts of sub-
Saharan Africa.
From the late 1950s to the 1970s
chloroquine-resistant malaria spread
across Asia to Africa, leading to millions of
deaths.
Chloroquine was replaced by
sulphadoxine-pyrimethamine (SP), but
resistance to SP subsequently emerged in
western Cambodia and again spread to
Africa. SP was replaced by artemisinin
combination treatment, or ACT, and
experts now worry it is losing effect.
“The pace at which artemisinin resistance
is spreading or emerging is alarming,” said
Philippe Guerin, director of the
Worldwide Antimalarial Resistance
Network.
Woodrow noted that thanks to advances in
the science of genetic analysis, researchers
tracking artemisinin antimalarials were in
“the unusual position of having molecular
markers for resistance before resistance
has spread globally”.
“The more we understand about the
current situation … the better prepared we
are to adapt and implement strategies to
overcome the spread of further drug
resistance,” he said.
