Healthcare (Commonwealth Union) – Malaria, one of the most formidable diseases known to humanity, has been a persistent challenge for Africa, affecting millions of people annually. In recent years, the emergence of artemisinin resistance has become a significant concern for the continent.
Artemisinin, a compound derived from the sweet wormwood plant, was first discovered in China in the 1970s as a potent anti-malarial drug. Artemisinin-based combination therapies (ACTs) have since become the frontline treatment for malaria, saving millions of lives worldwide. However, the rapid spread of artemisinin-resistant malaria parasites, in certain parts of the world, has raised alarm bells in the global health community.
The emergence of artemisinin resistance can be traced back to the late 2000s. In 2009, researchers identified the first case of artemisinin-resistant malaria parasites in parts of Cambodia. Since then, the resistance has spread across other parts of the world.
The emergence of artemisinin resistance poses a significant threat to malaria control efforts in Africa, where the disease remains a leading cause of morbidity and mortality.
In the journal Science, twenty-eight prominent malaria researchers from ten different countries have issued a call to action.
“We must act now so we don’t repeat the catastrophic mistakes we made with chloroquine when it was used for too many years after it was no longer effective,” said co-author, Dr Mehul Dhorda, who is based at MORU, in Bangkok.
According to the Centre for Tropical Medicine and Global Health the group of researchers from the ten countries across Africa, Asia, and the Americas has noted that mutations suggesting artemisinin resistance have been detected in over 10% of malaria-infected individuals in Rwanda alert along with alerts in Ethiopia, Eritrea, , Uganda, and Tanzania. This development could mark the end of the exceptional effectiveness of artemisinin combination therapies (ACTs) in combating malaria in Africa over the past two decades.
“Now is the time to act before millions of people die due to increasingly ineffective antimalarial treatments,” said Prof Olugbenga Mokuolu, Department of Paediatrics and Child Health, College of Health Sciences, University of Ilorin, in Nigeria.
Artemisinin resistance not only jeopardizes the efficacy of current anti-malarial treatments but also threatens the progress made in malaria control over the past two decades. The widespread use of ACTs has contributed to a significant reduction in malaria cases and deaths in Africa. However, the emergence of resistance could potentially reverse these gains, leading to increased morbidity, mortality, and economic burden.
Moreover, artemisinin resistance has the potential to exacerbate existing health inequalities in Africa. Malaria disproportionately affects the poorest and most vulnerable populations, including pregnant women and children under five. The emergence of resistance could further widen these disparities, as the most vulnerable populations may be unable to access or afford alternative treatments.
To combat artemisinin resistance, a multifaceted approach is required, involving research, surveillance, and effective interventions. The development of novel anti-malarial drugs is crucial to combat artemisinin resistance. Researchers are currently exploring several promising compounds, including the synthetic peroxidation drug, OZ439, and the natural compound, tafenoquine. These drugs, in combination with other anti-malarial agents, could provide an effective alternative to ACTs.
Robust surveillance systems are essential to detect and track the spread of artemisinin resistance. Countries in sub-Saharan Africa may need investments in strengthening their surveillance capacities to ensure early detection and prompt response to emerging resistance.
Engaging local communities in malaria control efforts is crucial to ensure the success of interventions. By educating communities about the importance of early diagnosis and treatment, as well as the proper use of preventive measures, the spread of artemisinin resistance can be curtailed.
Artemisinin resistance to malaria in Africa is a growing concern with potentially devastating consequences for public health and socioeconomic development. To combat this threat, a concerted effort is required from governments, researchers, and international organizations. By investing in research, strengthening surveillance, and implementing effective interventions, it is possible to mitigate the impact of artemisinin resistance and continue the progress made in malaria control in Africa. As Malaria resists drugs the focus on the mosquitoes breeding places will be significant.
