13 Jan, 2011
A new report which was released in Dar es Salaam yesterday says the world risks losing its most potent treatment for malaria unless urgent steps are taken to prevent the development and spread of drug-resistant parasites.
The report was released by the World Health Organisation (WHO) in collaboration with Roll Back Malaria (RBM).
It said a global plan for Artemisinin Resistance Containment outlined necessary steps to contain and prevent resistance to artemisinins, which were a critical component of artemisinin-based combination therapies (ACTs), the most potent weapon in treating falciparum malaria, the deadliest form of the disease.
Resistance to artemisinins has already occurred in Cambodia-Thailand border areas.
"The usefulness of our most potent weapon in treating malaria is now under threat," said WHO director general Dr Margaret Chan.
The new plan takes advantage of an unprecedented opportunity in the history of malaria control - to stop the emergence of drug resistance at its source and prevent further international spread. “The consequences of widespread artemisinin resistance compel us to seize this opportunity," Dr Chan said.
The global plan aimed at containing and preventing artemisinin resistance through a five-step action plan including stop the spread of resistant parasites, a fully funded and implemented malaria control agenda, as outlined in the global malaria action plan, would address many of the needs for the containment and prevention of artemisinin resistance.
She said, however that, additional funding would be needed to stop the spread of resistant parasites in areas where there was evidence of artemisinin resistance. The global plan estimated that it would cost an additional USD 10-20 per person in some areas of confirmed resistance.
She said the second plan was to increase monitoring and surveillance for artemisinin resistance. The director general said WHO estimated last year that, only 31 of the 75 countries that should be conducting routine testing of the efficacy of ACTs did so.
“There is a risk of artemisinin resistance emerging silently in areas without ongoing surveillance,” she said.
The other measure according to the WHO is to improve access to malaria diagnostic testing and rational treatment with ACTs. It is said that the therapies are frequently used to treat causes of fever other than malaria and unnecessary use of ACTs can increase the risk of resistance.
In order to reduce the number of patients who do not have malaria taking the therapies, WHO recommends diagnostic testing of all suspected malaria cases before treatment.
It says there is an urgent need to develop more rapid techniques for detecting resistant parasites and develop new classes of antimalarial medicines to eventually replace the ACTs.
''Effective containment of artemisinin resistance will significantly improve our capability to sustain current control achievements at country level,'' said Prof Awa Coll-Seck, Executive Director of the Roll Back Malaria Partnership.
''We now have a coordinated plan to stop the spread of resistant parasites but we need additional funding to fully implement it,'' Coll-Seck reminded the international community.
WHO estimates that the number of malaria cases has fallen by over 50 per cent in 43 countries over the past decade. A recent modelling analysis of malaria prevention in 34 African countries estimates that over 730,000 lives were saved between 2000 and last year, nearly three quarters of them since 2006, when the use of both insecticide treated mosquito nets and ACTs became more widespread.
The loss of ACTs as an effective treatment will likely result in a significant increase in malaria-related deaths. "We have made tremendous progress over the past decade in the fight against malaria," noted Dr Robert Newman, the director of the WHO Global Malaria Programme, adding:
"If we are to sustain these gains and achieve the health-related Millennium Development Goals, then it is essential that we work together to overcome the threat of artemisinin resistance," he explained.
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