Malaria drug resistance poses 'enormous threat'

Two boys living in the Thai-Myanmar border stand inside a mosquito net. Researchers have found drug-resistance mutations in malaria parasites along Mynamar's borders. (Sukree Sukplang/Reuters)

Signs of total resistance to a key anti-malarial drug have been detected in a large swath of Myanmar's border with India, raising fears for scientists who aim to eliminate the killer disease.

Artemisinin is a vital drug in the fight against malaria infections. If drug resistance spreads from Asia or independently in the continent of Africa as it has before, then millions would be left empty-handed.

In a new study, researchers used blood samples from patients with symptoms at 55 malaria treatment centres across Mynamar and its border regions to test for a resistant mutation in the plasmodium parasite. 

In Friday's issue of the Lancet Infectious Diseases, researchers presented a map showing the mutation was prevalent in Mynamar's northwest border with India.

Mynamar is considered the front line in the battle against artemisinin resistance, said the study's senior author, Dr. Charles Woodrow from the Mahidol-Oxford Tropical Medicine Research Unit in Bangkok. A previous study suggests the country has substantially more malaria than other nations in southeast Asia.

"Our study shows that artemisinin resistance extends over more of southeast Asia than had previously been known, and is now present close to the border with India. This finding expands the area in which containment and elimination are needed to prevent the possibility of global spread of artemisinin resistance," the study's authors concluded.

"A vigorous international effort to contain this enormous threat is needed."

Study co-author Philippe Guerin, director of the Worldwide Antimalarial Resistance Network, said the pace of artemisinin resistance spread or emergence is alarming. 

Last year, a study in western Cambodia showed switching to another anti-malarial improved the effectiveness of combination treatments based on artemisinin, but only temporarily. 

The World Health Organization reported last year that malaria death rates decreased by 47 per cent between 2000 and 2013. It attributed the success to greater access to insecticide-treated bed nets, more accurate diagnostic tests and effective treatments such as artemisinin-based combinations. 

The research in Friday's Lancet Infectious Diseases was funded by the Bill & Melinda Gates Foundation, the Wellcome Trust and the ExxonMobil Foundation.

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