Scientists are alarmed by the escalating threat of drug-resistant malaria in Africa, calling for immediate and substantial action to curb its spread. In East Africa, malaria parasites have developed resistance to artemisinin, an important drug for treating malaria. This resistance has increased dramatically in some regions, from less than 1% to more than 20% of cases in just three years.
The latest major wave of antimalarial drug resistance in Africa has tripled child mortality rates, highlighting the serious potential consequences of inaction. Twenty-eight leading malaria experts from 10 countries issued a call to action in the journal Science, underscoring the urgency of the situation.
Spreading Resistance
Artemisinin-resistant parasites first appeared in Rwanda, later appearing in Uganda and Eritrea. These resistant strains have now spread within these countries and beyond, with more than 10% of malaria cases in Ethiopia, Eritrea, Rwanda, Uganda and Tanzania involving drug-resistant parasites. Professor Olugbenga Mokuolu of the University of Ilorin in Nigeria said: "Immediate action is critical to prevent millions of deaths from increasingly ineffective malaria treatment."
History lessons
The situation mirrors the past, when malaria parasites developed resistance to chloroquine in the 1970s. By the 1980s, resistance had spread throughout East Africa, leading to a dramatic increase in malaria mortality. A similar pattern could repeat itself if artemisinin-based therapy fails, warned Dr Mehul Dhorda of the Mahidol Oxford Tropical Medicine Research Unit in Thailand.
Proposed solutions
To combat the threat, experts recommend several strategies that target both the malaria parasites and the mosquitoes that transmit the disease. They include:
Addition of a third drug: inclusion of a third drug in artemisinin combination therapy to complicate the development of resistance.
Expanded coverage: expanding the use of insecticide-treated bed nets and long-lasting insecticides in homes.
Targeted vaccination: use of newly developed malaria vaccines for people of all ages in artemisinin-resistant regions.
Supporting public health care: ensuring access to treatment through community health workers.
Fast data exchange: Improved data exchange speed for resistant strains to ensure fast response.
Application for funding
Experts are calling on international donors, including the Global Fund and the US President's Malaria Initiative, to increase funding for malaria control and eradication programs. "Investing now in expanded interventions will save significantly more in future efforts to contain widespread resistance," said Ntuli Kapologwe, director of preventive services at Tanzania's Ministry of Health.
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