Spread of Malaria Feared as Drug Loses Potency

TASANH, Cambodia — The afflictions of this impoverished nation are on full display in its western corner: the girls for hire outside restaurants, the badly rutted dirt roads and the ubiquitous signs that warn “Danger Mines!”



Chet Chen, 18, lying listless with malaria in Tasanh, Cambodia.

But what eludes the naked eye is a potentially graver problem, especially for the outside world. The parasite that causes the deadliest form of malaria is showing the first signs of resistance to the best new drug against it.

Combination treatments using artemisinin, an antimalaria drug extracted from a plant used in traditional Chinese medicine, have been hailed in recent years as the biggest hope for eradicating malaria from Africa, where more than 2,000 children die from the disease each day.

Now a series of studies, including one recently published in The New England Journal of Medicine and one due out soon, have cemented a consensus among researchers that artemisinin is losing its potency here and that increased efforts are needed to prevent the drug-resistant malaria from leaving here and spreading across the globe.
(..)
“Many of us think this should be treated on the same order as SARS,” said Col. Alan J. Magill, a researcher at the Walter Reed Army Institute of Research in Maryland. “This should be a global emergency that is addressed in a global fashion.” SARS, the respiratory disease that spread rapidly through Asia and beyond in 2003, killed more than 700 people.
(..)
Different regions rely on different artemisinin combinations. The Cambodian government recommends that artemisinin be combined with mefloquine, which was developed by the American military and is known commercially as Lariam. Artemether, a derivative of artemisinin, is often combined with another antimalarial drug, lumefantrine. This was recently judged to be the most effective combination in a study of children in Papua New Guinea.

The same combination is also expected to be approved for sale in the United States soon, marketed by Novartis and mainly intended for people traveling overseas or for those who arrive in the United States with malaria.

The mosquito responsible for transmission of malaria is still endemic in the United States. But modern housing, better access to health care and the use of insecticides have virtually eradicated the disease in wealthier countries.