• Burmese
Monday, July 14, 2025
No Result
View All Result
NEWSLETTER
The Irrawaddy
28 °c
Yangon
  • Home
  • News
    • Burma
    • Politics
    • World
    • Asia
    • Myanmar’s Crisis & the World
    • Ethnic Issues
    • War Against the Junta
    • Junta Cronies
    • Conflicts In Numbers
    • Junta Watch
    • Fact Check
    • Investigation
    • Myanmar-China Watch
    • Obituaries
  • Politics
  • Business
  • Opinion
    • Commentary
    • Guest Column
    • Analysis
    • Editorial
    • Stories That Shaped Us
    • Letters
  • Junta Watch
  • Ethnic Issues
  • War Against the Junta
  • In Person
    • Interview
    • Profile
  • Books
  • Donation
  • Home
  • News
    • Burma
    • Politics
    • World
    • Asia
    • Myanmar’s Crisis & the World
    • Ethnic Issues
    • War Against the Junta
    • Junta Cronies
    • Conflicts In Numbers
    • Junta Watch
    • Fact Check
    • Investigation
    • Myanmar-China Watch
    • Obituaries
  • Politics
  • Business
  • Opinion
    • Commentary
    • Guest Column
    • Analysis
    • Editorial
    • Stories That Shaped Us
    • Letters
  • Junta Watch
  • Ethnic Issues
  • War Against the Junta
  • In Person
    • Interview
    • Profile
  • Books
  • Donation
No Result
View All Result
The Irrawaddy
No Result
View All Result
Home News Burma

Malaria Battle Set to Ramp Up

Samantha Michaels by Samantha Michaels
June 18, 2015
in Uncategorized
Reading Time: 5 mins read
0 0
A A
Malaria Battle Set to Ramp Up

Malaria medicine is administered at the Mae Tao clinic on the Thai-Myanmar border in 2013. (Photo: JPaing / The Irrawaddy)

4.7k
VIEWS
Share on FacebookShare on Twitter

Drug-resistant malaria appears to have taken hold in much of Myanmar, and scientists aren’t exactly sure how. It may have spread here from elsewhere, or it may have emerged independently, but in any case, the strategy to fight it seems set for a major change.

More than a decade ago, the deadliest type of malaria-causing parasite, Plasmodium falciparum, evolved in Cambodia, becoming resistant to the main anti-malaria drug, artemisinin.

For several years, resistant parasites have also been detected along the Myanmar-Thailand border, as well as in Bago Region, but earlier this year, scientists revealed that the problem may be much greater than was previously realized.

RelatedPosts

Ma Win Maw Oo, soaked in blood, is carried by two medics on Sept. 19, 1988 in downtown Yangon after troops gunned down peaceful demonstrators. / S. Lehman / Visions

Why the Past Can’t Be Put to Rest

September 19, 2020
8.2k
Renowned Myanmar language teacher John Okell is still inspiring students, five decades on.

Love of the Lingo

August 5, 2020
10.2k
Maung Thaw Ka (standing, left) accompanies Daw Aung San Suu Kyi (with microphone) during her first-ever speech to the Myanmar public, delivered outside Yangon General Hospital on Aug. 24, 1988, two days before her historic address to a huge crowd outside the city’s Shwedagon Pagoda.

A Tribute to Maung Thaw Ka

June 11, 2020
7.6k

In February, a study published in The Lancet Infectious Diseases journal showed that at 55 malaria treatment centers across the country, nearly 40 percent of parasite samples had genetic mutations linked to artemisinin resistance. In fact, these mutations were found in seven of the country’s 10 administrative regions, including in Homalin, Sagaing Region, only 15 miles from the Indian border.

And that’s a big deal. Myanmar—stretching from the Bay of Bengal and the Andaman Sea in the south to the Himalayan mountains in the north—offers the only known path for resistant parasites to make their way contiguously to the Indian subcontinent, and from there to Africa, where the disease already kills hundreds of thousands of children every year. This has happened in the past with other anti-malarial drugs that were once powerful but are now ineffective, resulting in the loss of millions of lives.

“Clearly, Myanmar is an important part of the frontline in the battle to contain artemisinin resistance,” the scientists wrote in the study. But “the pace at which the geographical extent of artemisinin resistance is spreading is faster than the rate at which control and elimination measures are being developed and instituted, or new drugs being introduced.”

Translation: Current strategies for fighting the disease aren’t working, and, should artemisinin fail completely, there’s no other medicine ready to replace it.

Artemisinin-combination therapies are still 95 percent effective in Sagaing, according to Dr. Pascal Ringwald of the World Health Organization’s Global Malaria Program. But in the event that they begin to fail, the results could be catastrophic in Myanmar, whose health-care system is still in shambles after half a century of neglect during military rule. The country also faces Southeast Asia’s largest malaria burden, with more than 333,000 confirmed cases reported in 2013, down from 480,000 cases in 2012.

Scientists caution that more testing is needed to confirm whether drug resistance is present so close to India. The sample size from the study was relatively small, and debate is ongoing over whether the genetic mutations discovered are directly linked to resistance, or are merely indirect indicators of possible resistance, according to Dr. Francois Nosten, a Thailand-based malaria expert who contributed to the study.

Jumping or Popping

If history repeats itself and drug resistance winds up in Africa again, it’s unclear whether it will spread there from Southeast Asia or emerge independently.

Dr. Christopher Plowe, director of the Institute for Global Health at the University of Maryland, which has major programs in Myanmar, says a sort of “paternity testing” for malaria parasites allows scientists to determine whether they are related to parasites in other locations. In Southeast Asia, he says, it appears resistant parasites are sometimes spreading from one place to another, in a process known as “jumping.” But in other cases, he says, they’re emerging independently, in a process known as “popping.”

“There are jumps between Cambodia and Vietnam, and in the published literature only pops so far in Myanmar,” he says, adding that jumps have also been seen across the border between western Thailand and southeastern Myanmar. “The fact that both are happening is indeed the worst possible scenario.”

“It may be just a matter of time until artemisinin resistance takes hold in Africa, whether it is by popping or jumping… Great progress is being made in some African countries, less in others, but there is a nightmare scenario around the corner if we lose artemisinins: huge resurgences everywhere with no effective drugs to offer for treatment, and millions of deaths, as we had in the 1980s and 1990s.”

Earlier this year, scientists said they had detected malaria parasites in Kenya with mutations linked to resistance, and those mutations were different from the mutations found on parasites in Cambodia.

If resistance is popping up independently, Dr. Plowe says, it makes no sense to put up a firewall to block it, as countries in Southeast Asia have been trying to do for years. “A strategy of containment—the so-called firewall—is not likely to work, and we need to move fast to eliminate malaria” from the Greater Mekong Subregion and Africa, he says.

In 2011, the World Health Organization (WHO) called for a containment strategy to fight malaria globally, and two years later it launched an emergency initiative to contain drug resistance in the Greater Mekong Subregion—by distributing bednets, spraying insecticide and treating anyone who tested positive for the disease. Heavyweight donors like the Bill & Melinda Gates Foundation and the Global Fund to Fight AIDS, Tuberculosis and Malaria were eager to help; the latter put down US$100 million over three years to fight malaria in the region. The WHO estimated at the time that $350 million more would be needed for Southeast Asia’s containment effort through 2015.

Elimination

Francois Nosten, the Thailand-based malaria expert, isn’t convinced that drug-resistant malaria has only emerged independently in Myanmar, as Dr. Plowe suggests.

“The jury is still out,” Dr. Nosten says. But he’s sure that containment is not working well enough, and that it’s time for a strategy change. “We need to eliminate as much malaria as we can,” he says.

Others agree. In mid-May, the WHO was preparing to ask member states in the Greater Mekong Subregion to adopt a strategy of complete elimination—taking steps to prevent any new cases of malaria from arising.

With the new strategy, health workers would continue to distribute bed nets, spray insecticide and treat people with the disease, but they could also go a step further: In some cases, they could give anti-malarial medicine to entire villages in malaria hotspots, including to people who don’t show any symptoms or feel sick.

This technique, known as mass drug administration, is set to be included in the elimination strategy, according to Izaskun Gaviria, the Myanmar portfolio manager at the Global Fund, which launched a pilot project for mass drug administration in Southeast Asia last year, including in Myanmar.

“No adverse effects have been documented so far, none whatsoever, which is quite encouraging,” she said. “Initial data indicates that the pilot project has been successful.”

Southeast Asian governments have already set a goal to eliminate malaria from the region over the next 15 years, Gaviria added. “Of course, some countries can do it faster than others—Myanmar being for obvious reasons the last one—but we are hoping that by 2030 all the countries will have eliminated malaria,” she said.

But developments in Cambodia could point to new problems. There, parasites are starting to show resistance to piperaquine, a partner drug that’s used in combination with artemisinin.

“It is extremely concerning,” Gaviria said, noting that piperaquine resistance has not yet been detected in other countries. “Artemisinin makes you feel good within a very short period of time, but it does not kill all the parasite flow—it is the partner drug that does that—so if we lose the partner drug, we will be in big trouble.”

A British pharmaceutical company is also developing what could be the world’s first malaria vaccine, but it has only protected about one-third of children vaccinated during testing, and the research and licensing for it are focused on Sub-Saharan Africa. “So its use in Asia, while possible, is less likely in the near term,” Gaviria said.

This article originally appeared in the June 2015 issue of The Irrawaddy magazine.

Your Thoughts …
Tags: A_FactivaFeaturesMagazine
Samantha Michaels

Samantha Michaels

Reuters

Similar Picks:

Aung San: A Legacy Unfulfilled
Stories That Shaped Us

Aung San: A Legacy Unfulfilled

by Kyaw Zwa Moe
February 11, 2015
14.6k

Born in 1915, Aung San’s aspirations for a unified and democratic Myanmar went unfulfilled in his lifetime and have yet...

Read moreDetails
From Aung San’s Driver to Centenarian
Stories That Shaped Us

From Aung San’s Driver to Centenarian, a Long and Winding Road

by Kyaw Zwa Moe
April 29, 2015
12.7k

As the man who drove Gen. Aung San to Panglong, 100-year-old U Khan is proud of the small part he...

Read moreDetails
The Safe Sex Talk
Specials

The Safe Sex Talk, Burmese Style

by Samantha Michaels
January 20, 2014
27.7k

In a Buddhist-majority country where talking about intimacy is taboo, efforts are under way to develop a better system for...

Read moreDetails
Kokang: The Backstory
Burma

Kokang: The Backstory

by Bertil Lintner
March 9, 2015
18k

The site of fierce recent fighting, Shan State’s Kokang region has a complex history of feuding warlords and thriving drug...

Read moreDetails
Inspiring Women of Burma  
Burma

Inspiring Women of Burma  

by The Irrawaddy
March 18, 2016
33.6k

The contributions of some of Burma’s leading female figures are highlighted in the final part of a series that ran...

Read moreDetails
The Life of Burmese Male Sex Workers in Chiang Mai
Features

The Life of Burmese Male Sex Workers in Chiang Mai

by Kyaw Kha
November 18, 2014
46.7k

Dozens of young men from poor villages in Shan State work as sex workers in gay show bars in northern...

Read moreDetails
Load More
Next Post
Suu Kyi Worries that Reform is a ‘Total Illusion’

Suu Kyi Worries that Reform is a ‘Total Illusion’

Yin Myo Su Wins Global Leadership Award in Washington

Yin Myo Su Wins Global Leadership Award in Washington

No Result
View All Result

Recommended

Trump’s Tariffs to Hit Myanmar’s Garment Manufacturers Hard

Trump’s Tariffs to Hit Myanmar’s Garment Manufacturers Hard

5 days ago
1.2k
China’s Surveillance State Watches Everyone, Everywhere

China’s Surveillance State Watches Everyone, Everywhere

6 days ago
1.1k

Most Read

  • ‘Las Vegas in Laos’: the Riverside City Awash With Crime

    ‘Las Vegas in Laos’: the Riverside City Awash With Crime

    shares
    Share 0 Tweet 0
  • Myanmar Junta Chief Thanks Trump for Shutting Down VOA and RFA

    shares
    Share 0 Tweet 0
  • Myanmar Junta’s ‘Living Fence’ on Thai Border Falls to Karen Resistance

    shares
    Share 0 Tweet 0
  • KIA Denies Rumor Chief Under House Arrest in China

    shares
    Share 0 Tweet 0
  • TNLA Invites Investment in Ruby and Mineral Towns Amid Myanmar Junta Onslaught

    shares
    Share 0 Tweet 0

Newsletter

Get The Irrawaddy’s latest news, analyses and opinion pieces on Myanmar in your inbox.

Subscribe here for daily updates.

Contents

  • News
  • Politics
  • War Against the Junta
  • Myanmar’s Crisis & the World
  • Conflicts In Numbers
  • Junta Crony
  • Ethnic Issues
  • Asia
  • World
  • Business
  • Economy
  • Election 2020
  • Elections in History
  • Cartoons
  • Features
  • Opinion
  • Editorial
  • Commentary
  • Guest Column
  • Analysis
  • Letters
  • In Person
  • Interview
  • Profile
  • Dateline
  • Specials
  • Myanmar Diary
  • Women & Gender
  • Places in History
  • On This Day
  • From the Archive
  • Myanmar & COVID-19
  • Intelligence
  • Myanmar-China Watch
  • Lifestyle
  • Travel
  • Food
  • Fashion & Design
  • Videos
  • Photos
  • Photo Essay
  • Donation

About The Irrawaddy

Founded in 1993 by a group of Myanmar journalists living in exile in Thailand, The Irrawaddy is a leading source of reliable news, information, and analysis on Burma/Myanmar and the Southeast Asian region. From its inception, The Irrawaddy has been an independent news media group, unaffiliated with any political party, organization or government. We believe that media must be free and independent and we strive to preserve press freedom.

  • Copyright
  • Code of Ethics
  • Privacy Policy
  • Team
  • About Us
  • Careers
  • Contact
  • Burmese

© 2023 Irrawaddy Publishing Group. All Rights Reserved

Welcome Back!

Login to your account below

Forgotten Password?

Retrieve your password

Please enter your username or email address to reset your password.

Log In
No Result
View All Result
  • Home
  • News
    • Burma
    • Politics
    • World
    • Asia
    • Myanmar’s Crisis & the World
    • Ethnic Issues
    • War Against the Junta
    • Junta Cronies
    • Conflicts In Numbers
    • Junta Watch
    • Fact Check
    • Investigation
    • Myanmar-China Watch
    • Obituaries
  • Politics
  • Opinion
    • Commentary
    • Guest Column
    • Analysis
    • Editorial
    • Stories That Shaped Us
    • Letters
  • Ethnic Issues
  • War Against the Junta
  • In Person
    • Interview
    • Profile
  • Business
    • Economy
    • Business Roundup
  • Books
  • Donation

© 2023 Irrawaddy Publishing Group. All Rights Reserved

This website uses cookies. By continuing to use this website you are giving consent to cookies being used. Visit our Privacy and Cookie Policy.