Drug-resistant malaria could spread fast

Drug-resistant malaria could spread from south-east Asia to Africa within months, putting millions of children's lives at risk, a leading expert warned on January 12.
Nicholas White, professor of tropical medicine at Mahidol University in Bangkok, called for a war before it is too late on the malaria strain resistant to the drug artemisinin that first emerged along the Thai-Cambodian border in 2007.
This longer-to-treat form of malaria is suspected of breaking out along the Thai-Myanmar frontier and in a province of Vietnam, where tests are under way to confirm it, but the great fear is of it reaching Africa. "It is a time bomb, it is ticking. It has the potential of killing millions of African children," White told Reuters.
A migrant worker who doesn't even show symptoms could spread the resistant parasite beyond Asia, he said. "It could be a Chinese worker acting as an adviser in Cambodian forests who then hops on a plane to Africa. It could go off at any minute."
Earlier, the World Health Organisation (WHO) launched a $175 million annual plan to contain and prevent the global spread of the artemisinin-resistant parasite beyond the Mekong region.
The WHO, which said last month the world could stop malaria deaths by 2015 with massive investment, called for faster research and development of new anti-malarial drugs. But White, widely credited with helping to first identify the resistant form, called the WHO plan "somewhat anodyne."
"I think we should fight this as a war. We are too fractured as a community," he told an experts meeting at WHO headquarters.
"What seems to be lacking is a sense of urgency. People talk in terms of years. I think we should be thinking in terms of months. Time is crucial," he said. Artemisinin, derived from sweet wormwood, or the Artemisia annua plant, is the most potent drug available against malaria, especially when used in artemisinin combination therapy (ACT), which links it with other drugs.
"ACTs are the gold standard. They are the most effective treatment for falciparum malaria, the most deadly form of malaria," WHO director-general Margaret Chan said in a speech. "The consequences of widespread resistance to artemisinins would be catastrophic."
Resistance to previous generations of anti-malarial drugs such as chloroquine spread from the same Mekong region to India and then Africa, killing millions, experts say. "This part of the world is the historical epicenter for the emergence of drug-resistant malaria parasites. History tells us what to expect," Chan said.
White agreed, telling Reuters: "There is a horrible, chilling parallel. It is not as if we haven't been warned." Malaria infects about 243 million people world-wide a year, causing an estimated 863,000 deaths, making it a major killer especially among African children.
Yet few promising alternatives are available in the immediate research and development pipeline, a WHO report said. Some 5 million compounds are being screened as potential anti-malarials, 20,000 of which show promise, according to Dr. David Reddy, the new CEO of the Medicines for Malaria Venture, a public-private drugs partnership.
"That is how wide we have to cast the net in order to get a handful of drugs that will be tomorrow's medicines," he said. Swiss drugmaker Novartis and Sanofi-Aventis of France make the most widely-used ACTs, which treat 80 million and 45 million patients respectively a year, it said.