Emerging Setbacks in the Fight Against Malaria

The world community has made significant progress over the past few decades in battling one of humanity's oldest and most deadly enemies--malaria. Now, however, there is evidence emerging of how difficult this fight can be. BBC News has the story:

Scientists have found new evidence that resistance to the front-line treatments for malaria is increasing.
They have confirmed that resistant strains of the malaria parasite on the border between Thailand and Burma, 500 miles (800km) away from previous sites.
Researchers say that the rise of resistance means the effort to eliminate malaria is "seriously compromised".
The details have been published in The Lancet medical journal.For many years now the most effective drugs against malaria have been derived from the Chinese plant, Artemisia annua. It is also known as sweet wormwood.
In 2009 researchers found that the most deadly species of malaria parasites, spread by mosquitoes, were becoming more resistant to these drugs in parts of western Cambodia.

While this research has focused on Asia, the same issue almost certainly is emerging in Sub-Saharan Africa, where malaria takes its biggest toll.

Prof Francois Nosten, who is part of the research team that has carried out the latest work, says the development is very serious.
"It would certainly compromise the idea of eliminating malaria that's for sure and will probably translate into a resurgence of malaria in many places," he said.
Another scientist involved with the study is Dr Standwell Nkhoma from the Texas Biomedical Research Institute."Spread of drug-resistant malaria parasites within South East Asia and overspill into sub-Saharan Africa, where most malaria deaths occur, would be a public health disaster resulting in millions of deaths."

The problem here is that the focus of most research and community-based programs remains on prevention (especially treated bednets), rather than treatment.

Prof Nosten says the current spread of resistance could be similar to what happened in the 1970s with chloroquine, a drug that was once a front-line treatment against the disease.
"When chloroquine resistance reached Africa in the middle of the 1970s it translated into a large increase in the number of cases and the number of children who died increased dramatically."
"If we were to lose artemisinin then we don't have any new drugs in the pipeline to replace them. We could be going back 15 years to where cases were very difficult to treat because of the lack of an efficacious drug."