Drug-resistant malaria parasites have spread to border regions of Southeast Asia, seriously threatening global efforts to control and eliminate the mosquito-borne disease, researchers said on Wednesday.
The scientists, who analyzed blood samples from 1,241 malaria patients in 10 countries across Asia and Africa, found that resistance to the world’s most effective antimalarial drug, artemisinin, is now widespread in Southeast Asia.
However, the study found no signs yet of resistance in the three African sites it covered in Kenya, Nigeria and the Democratic Republic of the Congo.
“It may still be possible to prevent the spread of artemisinin-resistant malaria parasites across Asia and then to Africa by eliminating them, but that window of opportunity is closing fast,” said Nicholas White, a professor of tropical medicine at Oxford University who led the research and is chair of the Worldwide Antimalarial Resistance Network.
More than half the world’s people are at risk of malaria infection, and while there have been significant reductions in the numbers falling ill and dying from the mosquito-borne disease, it still kills more than 600,000 people each year.
Most malaria victims are children under five living in the poorest parts of sub-Saharan Africa.
From the late 1950s to the 1970s, chloroquine-resistant malaria parasites spread across Asia to Africa, leading to a resurgence of malaria cases and millions of deaths.
Chloroquine was replaced by sulphadoxine-pyrimethamine (SP), but resistance to SP subsequently emerged in western Cambodia and again spread to Africa.
SP was replaced by artemisinin combination treatment, or ACT, and experts say history may repeat itself for a third time.
White cautioned that conventional malaria control approaches would not be enough.
“We will need to take more radical action and make this a global public health priority, without delay,” he said in a statement released with his findings.
The study, published in the New England Journal of Medicine, enrolled infected adults and children at 15 trial sites in 10 malaria-endemic countries between May 2011 and April last year.
Patients received a six-day antimalarial treatment, three days of an artemisinin derivative and a three-day course of ACT, and researchers analyzed their blood to measure the rate at which parasites were cleared from it.
They found that artemisinin resistance in Plasmodium falciparum — the most deadly form of malaria-causing parasite — is now firmly established in the west of Cambodia, Thailand and Vietnam, and in eastern Myanmar and northern Cambodia.
There are also signs of emerging resistance in central Myanmar, southern Laos and northeastern Cambodia, they said.
“If resistance spreads out of Asia and into Africa, much of the great progress in reducing deaths from malaria will be reversed,” Wellcome Trust global health charity director Jeremy Farrar said. “This is not just a threat for the future, it is today’s reality.”
The WHO said last year that four countries in Southeast Asia had reported artemisinin resistance, and 64 countries found evidence of insecticide resistance.
While there are a few new antimalarial drugs in the pipeline, including a once-a-day medicine from the Swiss drugmaker Novartis and a vaccine from Britain’s GlaxoSmithKline, they are unlikely to be on the market and available for widespread use for at least several years yet.
CONFRONTATION: The water cannon attack was the second this month on the Philippine supply boat ‘Unaizah May 4,’ after an incident on March 5 The China Coast Guard yesterday morning blocked a Philippine supply vessel and damaged it with water cannons near a reef off the Southeast Asian country, the Philippines said. The Philippine military released video of what it said was a nearly hour-long attack off the Second Thomas Shoal (Renai Shoal, 仁愛暗沙) in the contested South China Sea, where Chinese ships have unleashed water cannons and collided with Philippine vessels in similar standoffs in the past few months. The China Coast Guard and other vessels “once again harassed, blocked, deployed water cannons, and executed dangerous maneuvers” against a routine rotation and resupply mission to
GLOBAL COMBAT AIR PROGRAM: The potential purchasers would be limited to the 15 nations with which Tokyo has signed defense partnership and equipment transfer deals Japan’s Cabinet yesterday approved a plan to sell future next-generation fighter jets that it is developing with the UK and Italy to other nations, in the latest move away from the country’s post-World War II pacifist principles. The contentious decision to allow international arms sales is expected to help secure Japan’s role in the joint fighter jet project, and is part of a move to build up the Japanese arms industry and bolster its role in global security. The Cabinet also endorsed a revision to Japan’s arms equipment and technology transfer guidelines to allow coproduced lethal weapons to be sold to nations
Thousands of devotees, some in a state of trance, gathered at a Buddhist temple on the outskirts of Bangkok renowned for sacred tattoos known as Sak Yant, paying their respects to a revered monk who mastered the practice and seeking purification. The gathering at Wat Bang Phra Buddhist temple is part of a Thai Wai Khru ritual in which devotees pay homage to Luang Phor Pern, the temple’s formal abbot, who died in 2002. He had a reputation for refining and popularizing the temple’s Sak Yant tattoo style. The idea that tattoos confer magical powers has existed in many parts of Asia
ON ALERT: A Russian cruise missile crossed into Polish airspace for about 40 seconds, the Polish military said, adding that it is constantly monitoring the war to protect its airspace Ukraine’s capital, Kyiv, and the western region of Lviv early yesterday came under a “massive” Russian air attack, officials said, while a Russian cruise missile breached Polish airspace, the Polish military said. Russia and Ukraine have been engaged in a series of deadly aerial attacks, with yesterday’s strikes coming a day after the Russian military said it had seized the Ukrainian village of Ivanivske, west of Bakhmut. A militant attack on a Moscow concert hall on Friday that killed at least 133 people also became a new flash point between the two archrivals. “Explosions in the capital. Air defense is working. Do not