Addressing Drug-Resistant Malaria: Integrated Approaches Offer a Promising Path Forward

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A recent article from The Lancet reveals that drug-resistant strains of the malaria parasite are emerging in Southeast Asia, rendering many malaria treatments increasingly inefficient and ineffective. Most worrying for the global health community, are the WHO-recommended artemisinin-based therapies, used to treat the majority of malaria cases, that have been found to fail in an increasing number of cases, leading to fears that drug-resistance could spread to India and Africa.

Some studies have suggested that genetic mutations in mosquitoes could lead to the proliferation of multidrug-resistant malaria parasites. This rapid genetic evolution is a great threat. In the greater Mekong region, which includes Cambodia and Laos, it is well-known that drug-resistance has been on the rise for a decade. This was emphasized in a randomized study - one of the two studies discussed in The Lancet – where researchers observed an overall failure rate of a two-drug combination therapy of up to 50 percent in the region going as high as the alarming rate of up to 90 percent failure in some districts. This discovery was incidental and occurred while the researchers were testing the efficacy of a new triple-drug combination--the two-drug combination was simply supposed to serve as the control group for the study. As early as 2014, Cambodian officials switched back to older medication protocols, as treatment failures of the artemisinin-based combination therapy (ACT) of dihydroartemisinin-piperaquine had already been documented. Due to this powerful trend, Thailand and Vietnam have started to move away from these ACT treatments, even though they are recommended by the WHO.

In order to tackle the ever-growing threat of drug-resistance, the malaria community needs to embrace a holistic and integrated approach that leverages new health products and tools alongside community monitoring approaches and digital solutions.

For example, approaches such as the efficient tracking of malaria patients, precise monitoring of mosquito populations, and a sharp focus on improving malaria diagnostics are promising avenues for curtailing the spread of drug-resistant parasites. More accurate and timely data of all kinds are needed in the malaria space in general, as highlighted in the World Health Organization’s 2018 Malaria Report. Integrated management can be implemented in malaria programs by leveraging digital tools to track mosquitoes and malaria patients. These tools are  crucial in the current context of possible resurgence in the number of malaria cases and the increased drug-resistance of the disease. Developing diagnostic solutions that are affordable, accessible, and reliable is another important piece of the puzzle – this is why the Business Alliance Against Malaria is making it a point to boost innovation in the malaria space through its Innovators’ Circle.  This aligns with the United Nations General Assembly’s agenda where there is no doubt that anti-microbial resistance and drug-resistance remain high on the global health agenda.