Millions at risk as main malaria drug loses potency

Resistance to artemesinin was first detected in Cambodia in 2009, but has now spread 800km west

The world's most effective malaria drug is losing its power, threatening the lives of millions of people around the globe.

Tests on the border between Thailand and Burma show that the most deadly form of the malaria parasite has developed resistance to artemesinin, the gold standard treatment for the disease for more than a decade.

Experts described the development as "very worrying indeed" and warned the effects could be "devastating". Malaria claimed the lives of 655,000 people, mainly children, in 2010, according to the World Health Organisation, which warned that figure could rise "dramatically".

However, some estimates put the actual annual death toll at more than one million.

The development almost certainly puts the global strategy to end malaria deaths by the UN's target date of 2015 beyond reach. The world has been striving to eliminate the disease for 50 years and a huge global effort in the past five years, galvanised by the intervention of Bill Gates, has seen rates halved in many countries. Those gains are now in danger of being reversed.

Artemesinin has long been regarded as a miracle cure for malaria because it works so quickly, has few side-effects and, up to now, has been almost 100 per cent effective. Resistance to it was first detected in western Cambodia in 2009, but has now spread 800km to the west.

Efforts to contain the resistant parasites and wipe them out were made following the earlier discovery but the latest findings suggest it may have been too little, too late.

Experts are alarmed because, twice before, resistance to the then gold standard anti-malarial drugs – chloroquine and sulfadoxine-pyrimethamine – has started in the same region before spreading to South-east Asia and Africa, leading to the deaths of millions of children.

Chloroquine, once given routinely to anyone with symptoms of malaria, is now frequently ineffective against the disease.

The latest findings, published in The Lancet, come from the Shoklo Malaria Research Unit which has been monitoring the disease on the Thai-Burmese border for more than a decade. Studies in more than 3,000 patients show that artemesinin is taking a third longer to clear malaria parasites from the blood than it did in 2001 (from 2.6 to 3.7 hours) – a clear sign it is becoming less effective.

Professor François Nosten, director of the unit, said: "We have now seen the emergence of malaria resistant to our best drugs, and these resistant parasites are not confined to western Cambodia. This is very worrying indeed and suggests that we are in a race against time to control malaria in these regions before drug resistance worsens, develops and spreads further.

"The effect of that happening could be devastating. Malaria already kills hundreds of thousands of people a year. If our drugs become ineffective, this figure will rise dramatically."

Professor Nick White, chairman of the Worldwide Antimalarial Resistance Network, added: "Initially, we hoped we might prevent this serious problem spreading by trying to eliminate all Plasmodium falciparum [the most lethal malaria parasite] from western Cambodia. While this could still be beneficial, this new study suggests that containing the spread of resistance is going to be even more challenging."

The researchers said there was "compelling evidence" that genetic changes underlay the emergence of resistance, based on a separate analysis of the genetic make up of the parasites.

Artemesinin is derived from an ancient Chinese herbal remedy. It is usually given in combination with other medicines that last longer in the bloodstream.

The theory was that by using therapies in combination to strike at the parasite, the chance of resistance emerging was sharply reduced. Demand for artemesinin combination therapies (ACTs) is thought to have exceeded 250 million courses in 2011.

Anne-Catrin Uhlemann and David Fidock of Columbia university, New York, write in The Lancet: "Antimalarial control efforts are vitally dependent on artemesinin combination treatments.

"Should these regimens fail, no other drugs are ready for deployment, and drug development efforts are not expected to yield new antimalarials until the end of this decade."

Suggested Topics
News
Jeremy Clarkson
people
News
Ben Little, right, is a Labour supporter while Jonathan Rogers supports the Green Party
general election 2015
News
The 91st Hakone Ekiden Qualifier at Showa Kinen Park, Tokyo, 2014
news
Life and Style
Former helicopter pilot Major Tim Peake will become the first UK astronaut in space for over 20 years
food + drinkNothing but the best for British astronaut as chef Heston Blumenthal cooks up his rations
Life and Style
ebookNow available in paperback
ebooks
ebookPart of The Independent’s new eBook series The Great Composers
News
Kim Wilde began gardening in the 1990s when she moved to the countryside
peopleThe singer is leading an appeal for the charity Thrive, which uses the therapy of horticulture
Sport
Alexis Sanchez celebrates scoring a second for Arsenal against Reading
football
Life and Style
health
Voices
An easy-peel potato; Dave Hax has come up with an ingenious method in food preparation
voicesDave Hax's domestic tips are reminiscent of George Orwell's tea routine. The world might need revolution, but we like to sweat the small stuff, says DJ Taylor
News
i100
News
Japan's population is projected to fall dramatically in the next 50 years (Wikimedia)
news
  • Get to the point
Latest stories from i100
Have you tried new the Independent Digital Edition apps?

ES Rentals

    Independent Dating
    and  

    By clicking 'Search' you
    are agreeing to our
    Terms of Use.

    iJobs Job Widget
    iJobs General

    Recruitment Genius: Project Implementation Executive

    £18000 - £23000 per annum: Recruitment Genius: They work with major vehicle ma...

    Recruitment Genius: Chiropractic Assistant

    £16500 per annum: Recruitment Genius: A Chiropractic Assistant is needed in a ...

    Recruitment Genius: Digital Account Executive - Midlands

    £18000 - £26000 per annum: Recruitment Genius: They work with major vehicle ma...

    Recruitment Genius: Web Developer

    £28000 - £30000 per annum: Recruitment Genius: This company provides coaching ...

    Day In a Page

    NHS struggling to monitor the safety and efficacy of its services outsourced to private providers

    Who's monitoring the outsourced NHS services?

    A report finds that private firms are not being properly assessed for their quality of care
    Zac Goldsmith: 'I'll trigger a by-election over Heathrow'

    Zac Goldsmith: 'I'll trigger a by-election over Heathrow'

    The Tory MP said he did not want to stand again unless his party's manifesto ruled out a third runway. But he's doing so. Watch this space
    How do Greek voters feel about Syriza's backtracking on its anti-austerity pledge?

    How do Greeks feel about Syriza?

    Five voters from different backgrounds tell us what they expect from Syriza's charismatic leader Alexis Tsipras
    From Iraq to Libya and Syria: The wars that come back to haunt us

    The wars that come back to haunt us

    David Cameron should not escape blame for his role in conflicts that are still raging, argues Patrick Cockburn
    Sam Baker and Lauren Laverne: Too busy to surf? Head to The Pool

    Too busy to surf? Head to The Pool

    A new website is trying to declutter the internet to help busy women. Holly Williams meets the founders
    Heston Blumenthal to cook up a spice odyssey for British astronaut manning the International Space Station

    UK's Major Tum to blast off on a spice odyssey

    Nothing but the best for British astronaut as chef Heston Blumenthal cooks up his rations
    John Harrison's 'longitude' clock sets new record - 300 years on

    ‘Longitude’ clock sets new record - 300 years on

    Greenwich horologists celebrate as it keeps to within a second of real time over a 100-day test
    Fears in the US of being outgunned in the vital propaganda wars by Russia, China - and even Isis - have prompted a rethink on overseas broadcasters

    Let the propaganda wars begin - again

    'Accurate, objective, comprehensive': that was Voice of America's creed, but now its masters want it to promote US policy, reports Rupert Cornwell
    Why Japan's incredible long-distance runners will never win the London Marathon

    Japan's incredible long-distance runners

    Every year, Japanese long-distance runners post some of the world's fastest times – yet, come next weekend, not a single elite competitor from the country will be at the London Marathon
    Why does Tom Drury remain the greatest writer you've never heard of?

    Tom Drury: The quiet American

    His debut was considered one of the finest novels of the past 50 years, and he is every bit the equal of his contemporaries, Jonathan Franzen, Dave Eggers and David Foster Wallace
    You should judge a person by how they peel a potato

    You should judge a person by how they peel a potato

    Dave Hax's domestic tips are reminiscent of George Orwell's tea routine. The world might need revolution, but we like to sweat the small stuff, says DJ Taylor
    Beige is back: The drab car colours of the 1970s are proving popular again

    Beige to the future

    Flares and flounce are back on catwalks but a revival in ’70s car paintjobs was a stack-heeled step too far – until now
    Bill Granger recipes: Our chef's dishes highlight the delicate essence of fresh cheeses

    Bill Granger cooks with fresh cheeses

    More delicate on the palate, milder, fresh cheeses can also be kinder to the waistline
    Aston Villa vs Liverpool: 'This FA Cup run has been wonderful,' says veteran Shay Given

    Shay Given: 'This FA Cup run has been wonderful'

    The Villa keeper has been overlooked for a long time and has unhappy memories of the national stadium – but he is savouring his chance to play at Wembley
    Timeless drama of Championship race in league of its own - Michael Calvin

    Michael Calvin's Last Word

    Timeless drama of Championship race in league of its own