Recent media reports concerning a possible re-emergence of malaria at the Thai-Burmese border are unfounded, according to Prof. Francois Nosten, the head of the Shoklo Malaria Research Unit in Mae Sot.
On April 5, the medical journal The Lancet reported that the deadly malaria parasite Plasmodium falciparum had developed resistance to artemisinin-based drugs in Cambodia and along the Thai-Burmese border.
The report based its findings on a survey of “half-life” clearance times of parasites from the bloodstream of malaria patients—tests which showed that the clearance times had lengthened over the past 10 years, indicating that the parasite carried by mosquitoes was developing some resistance to artesunate, the main artemisinin derivative.
Several news agencies and industry magazines have subsequently reported that the findings portend to a potential malaria outbreak at the Thai-Burmese border or, as the Science Daily reported on April 8, the “spectre of untreatable malaria.”
Speaking to The Irrawaddy on Tuesday, Prof. Nosten explained that the half-life tests were indeed a warning that the parasite was more resistant, but stressed that the artemisinin-combination treatments (ACTs)—the various cocktails of artemisinin-based drugs that are the front-line in treatment against falciparum malaria—are “still effective.”
“However, there is virtually no transmission of malaria at the refugee camps along the Thai-Burmese border,” he said. In fact, the refugee camps are probably “the safest place to be” in terms of malaria control, he added.
Some 140,000 refugees from Burma, mostly ethnic Karen, are housed in camps along the Thai-Burmese border. Each camp has at least one health centre, all of which are stocked with ACTs.
In addition to refugees, there are an equal or higher number of Burmese migrant workers in the Mae Sot area, many working in factories.
Artemisinin is a herb similar to sweet wormwood which is indigenous to southern China. Renowned as a “miracle drug” and up to 97 percent effective in treating falciparum malaria, it has been tried and tested positively at the Shoklo Malaria Research Unit (www.shoklo-unit.com) since 1991, but was only given the thumbs-up by the World Health Organisation in May 2004.
Since then ACTs have rendered other drugs obsolete, and have been accepted as the prototypical treatment across Asia, Africa and other tropical regions around the world.
To date, no substitute has been discovered for artemisinin and its finite number of combinations.
Prof Nosten insists he and his staff are taking the recent half-life clearance results “very seriously,” and that in the years ahead they will have to “look down the road toward a new generation of ACTs”—assuming of course that no other wonder drug is discovered.
In the meantime, he said, “more efforts are needed to eliminate malaria in the region before P. falciparum becomes completely resistant to the artemisinins.”