Successes from the use of artemisinin combination therapies have reduced malaria-related child mortality in half in parts of Africa. However counterfeit artemisinin drugs with lower than prophylactic dosages are creating resistance and turning the tide against the children of Africa.
Karen Masterson reports for The Henry L. Stimson Center that malarial parasites “have neutralized the effectiveness of every drug put to use in global health programs,” and that the World Health Organization’s use of artemisnins in the 1990s changed the devastation malaria had caused by providing rapid acting treatment and are now in use against malaria in 42 countries in Africa.
Because of the devastating losses malaria causes, there has been a worldwide effort to contain artemisinin-resistant malaria strains found only in along the Cambodian and Thai border, which was thwarted by armed conflict on the border over disputed territory in early 2011.
Robert Newman, director of the Global Malaria Programme for the World Health Organization, has said that his worries that the Cambodian-Thai border dispute could allow the resistant malaria to spread to Africa “wake me up at night” and would amount to a “public health disaster,” reported Masterson.
Artemisinin-based drugs are act quickly against infections and can be combined with older, slower-acting drugs to maintain therapeutic treatment long enough to kill off an infection. However, many governments lack secure drug distribution to ensure drugs are used properly and are protected from corruption, like theft and counterfeit.
Reports Masterson, “Counterfeit anti-malarials are especially troubling because a severe scarcity of health professionals has forced donor programs to make these drugs available over the counter at barely regulated kiosks whose owners operate under little or no oversight. Too often medicines are diluted or falsified to maximize profits. The sick receive inadequate doses that fail to clear the infection, creating conditions for resistance.”