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The World Health Organization today has released a new report on the drugs used to treat malaria, along with an appeal to nations to monitor and report any emergence of malarial drug resistance.
Roughly half the world’s population lives in areas where they risk infection from the malaria parasite.
Each year, roughly 250 million people are infected, and nearly a million people die from the disease (source WHO 10 Facts on Malaria).
Over the past couple of years, a new artemisinin resistant form of malaria has appeared along the Cambodian-Thailand border, prompting concerns that it could spread.
Hence the call for heightened monitoring and urgent requests that nations halt the use of oral artemisinin alone for the treatment of uncomplicated falciparum malaria, and use it as part of a drug cocktail instead.
First the news release, then a link to the report.
News release
WHO calls on malaria-endemic countries to strengthen monitoring of antimalarial drug efficacy
National monitoring essential step in preventing the emergence of malaria drug resistance
18 NOVEMBER 2010 | GENEVA -- WHO is calling on countries to be increasingly vigilant in monitoring antimalarial drug efficacy in order to allow for early detection of artemisinin resistance.1 This is one among several conclusions of the Global report on antimalarial drug efficacy and drug resistance: 2000–2010, released today. The report is based on 1100 studies conducted by national malaria control programs and research institutes over the ten-year period.
The report estimates that only 34% of malaria-endemic countries are complying with WHO recommendations to routinely monitor the efficacy of first- and second-line antimalarial medicines.2
"A greater political commitment to support and sustain national monitoring of the efficacy of antimalarial medicines is critical to prevent a wider emergence of artemisinin resistance", said Dr Pascal Ringwald of the Drug Resistance and Containment Unit, within WHO's Global Malaria Programme and one of the report authors.
Resistance to artemisinin
In February 2009, WHO confirmed that resistance to artemisinin had emerged on the Cambodia-Thailand border. Although patients infected were cured following treatment with an artemisinin-based combination therapy (ACT), the recovery took more time. In artemisinin-resistant areas, the high cure rates observed depend heavily on the efficacy of the non-artemisinin component of the combination.
Nonetheless, the report found that ACTs currently recommended by national malaria control programmes remain efficacious in treating malaria, with cure rates generally greater than 90%. In countries where the currently recommended ACT has a cure rate of less than 90%, policy change is ongoing to implement an efficacious replacement treatments for malaria.
"The emergence of artemisinin resistance on the Cambodia-Thailand border has been a wake-up call to the world to prevent its spread, increase monitoring, and preserve ACTs as the only effective treatment we have for falciparum malaria", said Dr Robert Newman, Director of WHO's Global Malaria Programme. "Prompt action will be critical to sustain progress in malaria control and achieve the health-related Millennium Development Goals."
Global report on antimalarial efficacy and drug resistance: 2000-2010
Authors: WHO
Publication date: 2010
Languages: English
ISBN: 9789241500470
Download [pdf 2Mb]
Questions and Answers [pdf 186kb]
Overview
This report provides a comprehensive, global overview of antimalarial drug efficacy and the resistance of malaria parasites to the antimalarial medicines used between 2000 and June 2010. Policy-makers in national ministries of health will benefit from this document, as it provides both a global and a regional picture of the efficacy of the antimalarial medicines currently used in national treatment programmes. In addition, the report will be a reference for scientists, enhancing their understanding of the complexity of antimalarial drug resistance.
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