Battling Malaria Secret Threat: The Shocking Truth About Antimalarial Drug Resistance Revealed!
In recent times, the efficacy of malaria medications has been repeatedly compromised by antimicrobial resistance (AMR). Over the past two decades, substantial strides have been taken to control malaria by employing various measures, such as insecticide-treated bed nets, diagnostics, and artemisinin-based medicines.
However, the parasite’s evolution has led to a diminishing effectiveness of current medications, progressing from chloroquine to sulfadoxine/pyrimethamine and, more recently, to artemisinin combination therapies, the primary compounds used for malaria treatment.
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Key Points:Malaria
Progress in reducing cases and deaths has stagnated due to factors like reduced funding and resource diversion during the COVID-19 pandemic.Partial resistance to artemisinin derivatives, the mainstay of malaria treatment, has been observed in South-East Asia for two decades and more recently in Africa.
If resistance spreads in Africa, with its high morbidity and mortality rates, and partner drugs become less effective, the impact on both mortality and morbidity could be devastating.
To regain momentum, a multifaceted approach is necessary, including the development of new anti medicines to address the emergence and spread of resistant parasites. In the short term, optimizing the use of existing drugs through diverse first-line therapies has been shown to delay resistance emergence in modeling studies.
Notably, a late-stage development involves a combination of artemether-lumefantrine plus amodiaquine as the first fixed-dose TACT (triple artemisinin-based combination therapy), demonstrating high efficacy against resistant parasites in studies.
Antimalarial Drug Resistance:
Microorganisms, including parasites, naturally undergo mutations, leading to antimicrobial resistance (AMR). This evolution compromises the effectiveness of antimalarial treatments, resulting in partial or complete resistance. Overreliance on artemether-lumefantrine in Africa raises concerns about potential resistance development.
Combating Antimalarial Drug Resistance:
Partial artemisinin resistance has been confirmed in various African countries.Combining drugs with different mechanisms of action reduces exposure to single compounds, making it harder for parasites to develop resistance.WHO’s strategy focuses on surveillance, regulating medicine use, limiting parasite spread, and stimulating research for new tools.
Multiple First-Line Therapies (MFT):
Implementing MFT, using different ACTs simultaneously, is crucial to preserve the effectiveness of artemether-lumefantrine and other ACTs.
MMV’s Approach:
Advocating MFT use through pilot studies.
Developing combination medicines targeting existing resistant parasite strains.Working on medicines with less frequent dosing regimens to reduce resistance likelihood.
Robust Pipeline for Antimalarials:
MMV emphasizes a robust pipeline for medicines to combat resistance, including patient-friendly formulations, high-quality WHO-prequalified medicines, discovery networks, and support for national control programs.
As of November 2022, the World Health Organization (WHO) has released a strategy to respond to antimalarial drug resistance in Africa, focusing on surveillance, regulating medicine use, limiting parasite spread, and stimulating research. MMV’s efforts align with this strategy, emphasizing the importance of optimizing existing drugs, developing new combinations, and maintaining a robust pipeline of antimalarials to counter the threat of resistance.
