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Call to action on drug-resistant malaria

September 22, 2011

Drug resistance to malaria is increasing in parts of Southeast Asia and a group of scientists are calling upon global health leaders to act swiftly to counter the emerging threat. In an article published in the New England Journal of Medicine, the authors exhort researchers, funders, and policy leaders to recognize the urgency of the problem and take action, address the important knowledge gaps and focus on eliminating the threat of artemisinin resistance with alacrity.

A co-author of the article, The Threat of Artemisinin-Resistant Malaria - A Call to Action, is Dr. Joel G. Breman of the Fogarty International Center at NIH.

The severe threat posed by emerging artemisinin resistance on the Cambodia-Thailand border is widely acknowledged, but an effective response requires that critical research questions be answered quickly.

"Twice before drug resistant malaria has originated along the Thailand-Cambodia border, and both times it spread to Africa," said senior author and long-time Fogarty grantee Christopher Plowe, a Howard Hughes Medical Institute Investigator and professor at the University of Maryland School of Medicine in Baltimore, who studies malaria drug resistance in Africa and Asia. "When chloroquine resistance got to sub-Saharan Africa, massive increases in malaria-related hospitalizations and deaths were seen, and there is every reason to expect the same result if artemisinin-resistance follows the same pattern."

"If we - and by 'we' I mean everybody, scientists, health officials, governments - don't get on top of this problem now, it could become a huge public health catastrophe," Plowe said.

In November 2010, Fogarty and the National Institute of Allergy and Infectious Diseases organized a meeting titled "Artemisinin-Resistant Malaria: Research Challenges, Opportunities, and Public Health Implications," at which the Centers for Disease Control and Prevention, the President's Malaria Initiative, the Food and Drug Administration, the World Health Organization and scientists from countries at peril participated.

The meeting recognized that Plasmodium falciparum resistance to artemisinin is present in Cambodia, Myanmar and Thailand, may be spreading to neighbors and has the potential to derail renewed global malaria eradication efforts. A number of research gaps to better understand and contain artemisinin resistance were identified.

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