The Resistance Challenge

In Tags: • June 12th, 2012

Following the recent Lancet article which expressed anxieties on strains of malaria showing resistance to artemesinin drugs, a panel of experts opened discussions.

Dr. Robert Newman, Director of the Global Malaria Programme, World Health Organisation, spoke about drug containment. Rob said that malaria resistance was a very important topic. There has been huge success he said, but there is a growing emergency as resistance to artemisinin has been detected. The drugs are still working but they are taking longer to work. If they failed we were running out of options.

Containment activities were in urgent need of financial help in Vietnam, Myanmar & Vietnam; this is where global malaria resistance traditionally starts. This is happening now. Technical support and resources were needed now as there was a limited opportunity to contain resistance, he said.
The reasons for growing resistance were:
Not enough resources
Mobile populations are creating a border problem
The widespread availability of ACTs
Drug regulation ?
Dr. Tim Wells, Chief Scientific Officer, Medicines for Malaria Venture spoke about MMV’s operational drug research. He updated the Group on MMV’s drug supply chain. 25 million pregnant women live in areas of high intense malaria transmission as a result 10,000 women and 200,000 children die as a result, he said.

We are in deep trouble if malaria spreads, but it wont happen overnight. The following combinations are being effective in some areas:
-Azithromycin and chloroquine combination is 97% effective in some areas.

Sulphadoxine & Pyramethamine taken in combination once per month during the rainy season protects thousands of pregnant women for 50p per year.

An Artusanate injection is saving the lives of those with severe malaria at a cost of $1 per treatment per year and has resulted in 3% reduction in malaria.

The next generation of drugs is being guided by biology. Screening the parasite is discovering novel molecules. These molecules are being made available to the NTD community. Artemisisin partners are under intense pressure; there is a need for rapid new killer compounds. Whole cell screening is being developed but this is in the early stages.

Celine Zegers de Beyl, Malaria Consortium, Monitoring & Evaluation Specialist, talked about Myanmar Artemisinin Resistance Containment; the survey plan currently being developed and how they were helping the resistance response.
She said that parts of Myanmar were vulnerable to malaria this because migrant workers not immune to malaria were coming into the country; an unregulated drug industry and the political situation which made relationships difficult. They had all helped to create a challenging environment.

There was a lack of monitoring and access to health care. Good quality data and strengthening surveillance was essential, it guided their strategy. Current control efforts were concentrated on containment. The Malaria Consortium was concentrating on prevention with the use of nets, health services and treatment.

Celeine said that we needed to ensure that existing drugs lasted longer. Too many countries were using monotherapies which had led to early resistance to existing drugs.