It is time to speed up. We must map malaria drug resistance in Africa now – University of Copenhagen

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12 August 2014

It is time to speed up. We must map malaria drug resistance in Africa now

Resistance to the artemisinin antimalarial drug, artesunate noted in the South East Asia. Yellow, orange and red pins illustrate where resistance is moderate to high (Source: Worldwide antimalarial resistance network).

Since 2011 the international malaria research community and WHO have warned against the growing resistance to the most used group of antimalarial drugs; the Artemisinin-based Combination Therapies (ACTs) in South-East Asia. It is a question of time before anti malarial drug resistance hits African countries and takes away the only efficient group of drugs available. We must start mapping this emergence of resistance in Africa immediately, explains a team of international malaria researchers including a WHO official in a comment published in the Lancet Infectious Diseases.  The good news is that the tool is cheap and right at hand.

Drug resistance observations from the last 30 years show how resistance against antimalarial drugs always begins in South-East Asia and continues to Africa. In 2006, malaria researchers first reported the alarming results of drug resistance along the Thai-Cambodian border and WHO soon thereafter called for action. There is no time to waste, says Associate Professor Michael Alifrangis at the Centre for Medical Parasitology at University of Copenhagen. He is part of the international network of researchers, which maps the global development of anti-malarial drug resistance.

- Today African countries have an effective group of drugs against malaria, the ACTs, and we still have a chance to preserve these or at least postpone the time before the drug becomes useless. The way forward is to map the drug resistance systematically and seek to contain the areas where the drug should not be used, says Alifrangis.

The available techniques today are very accurate. The researchers study the malaria parasite’s DNA in blood samples from the patients and they know exactly which parasite gene changes that are responsible for drug resistance. And the data material is right at hand:

 - Most African patients are tested for malaria with efficient rapid diagnostic tests. These tests are usually thrown away after usage, but if the health professionals collected them instead we would have a formidable data material to track drug resistance in the parasites DNA, says Alifrangis.

This calls for national health officials such as the national malaria control programs to establish the infrastructure to collect the rapid diagnostic tests for DNA analysis, but it also calls for the researchers to share the data immediately instead of keeping the results to themselves for later publications:

- As researchers we must find a way to publish the data immediately in an online database allowing health professionals and policy makers to follow the development of drug resistance as it happens and act appropriately. Scientific publications are often several years on their way and we simply cannot wait several years before we act. The recommendations must be available for the public far sooner, Alifrangis requests urgently.

The comment is published in the Lancet Infectious Diseases.

Contact: Michael Alifrangis, Tel. +45 23 45 18 04, e-mail

See the original article at Global Health's webpage.