Bloomberg Examines Drug-Resistant Malaria in Cambodia
Thursday, May 21, 2009
Bloomberg examined the emergence of drug-resistant malaria in Cambodia and the WHO's efforts to contain it. Counterfeit pills from China and other places are weakening the most effective drugs available to combat malaria, according to Bloomberg. Since 2006, Interpol has seized fake malaria drugs and arrested several people across Asia who were connected to counterfeit operations. However, Interpol's actions "hardly dented the global market for counterfeit pharmaceuticals," Bloomberg reports.
Although Cambodia has about 0.4% of the world's malaria cases, the country is a "breeding ground for strains that withstand medicines," Bloomberg writes. At least three once-potent malaria drugs lost their effectiveness in Cambodia before becoming useless in other parts of the world, according to the WHO. Now the same thing is happening with artemisinin-based combination therapies (ACTs), which are the "most-effective modern drugs against malaria," Bloomberg reports. A study conducted in 2008 – which has not yet been published – found that ACTs did not clear malaria parasites within two days from the blood of about 70% of patients in the city of Pailin, Cambodia, compared with 7% of patients in western Thailand. The drugs still clear the parasites, but they do so more slowly, which indicates that ACT-resistance is building.
The situation could evolve to become a global malaria "disaster," undoing decades of work to control the disease, Arjen Dondorp, the deputy director of the Wellcome Trust-Mahidol University Oxford Tropical Medicine Programme, said. Failing to contain drug-resistant malaria could lead to a "doom scenario," in which migrant workers would carry the parasite to Thailand, Myanmar and India, and the strain would later spread to Africa, Dondorp said.
In order to contain the drug-resistant malaria strain, the WHO hopes to eliminate malaria from western Cambodia through a program that is supported by $23 million from the Bill & Melinda Gates Foundation. In the next month, the program aims to screen about 25,000 people in the area and treat those who are diagnosed with malaria. The program will probably use GlaxoSmithKline's Malarone, which does not contain artemisinin and will minimize the pressure on ACTs, according to Eva-Maria Christophel, a WHO medical officer who will be implementing the program.
Cambodia also plans to start treating patients around Pailin with Chongqing Holley Pharmaceutical Company’s Duo-Cotecxin instead of ACTs, Duong Socheat, director of the nation’s malaria control program, said (Bennett, Bloomberg, 5/20).
The Kaiser Daily Global Health Policy Report is published by the Kaiser Family Foundation. © 2009 Henry J. Kaiser Family Foundation. All rights reserved.