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A drug-resistant form of malaria is quickly spreading through South-East Asia, a new study reveals. Unless radical action is taken immediately, the situation could worsen dramatically.

Malaria was always a pretty scary disease. Present in Africa, South America, parts of the Middle East, and South Asia, it is a life-threatening illness spread by mosquitoes infected with the Plasmodium microorganism. Around 207 million cases of malaria occurred in 2012, resulting in  approximately 627.000 deaths.

There are two ways to deal with malaria: preventing infected mosquitoes from spreading the disease to humans by killing the mosquitoes or using effective infect-repellents, and medication. Artemisinins are the most rapidly-acting malaria drugs on the market today and they have been used as a front-line treatment of the life-threatening infection, though almost always in combination with other drugs. 

That may be about to change. An artemisinin-resistant form of malaria has been spreading in South-East Asia and has now reached the Cambodia-Thailand border, a new study reveals.

Drug-Resistant Malaria 'Firmly Established' In South-East Asia

The study, published in the New England Journal of Medicine, analyzed blood samples from over 1,000 malaria patients at 15 test sites in 10 different countries. Malaria patients enrolled in the study received six days of anti-malarial treatment. This course of treatment included three days of an artemisinin derivative and a three-day course of ACT, or artemisinin combination treatment. They then investigated how long it took for the parasites to be cleared from the patients' blood stream. 

The research team found no evidence of drug-resistant malaria at the African test sites in Kenya, the Democratic Republic of Congo, and Nigeria. South-East Asia turned out to be a different story entirely. Malaria resistant to the commonly used artemisinins was found to be "firmly established in eastern Myanmar, western Cambodia and Thailand, and southern Vietnam, and it is emerging in southern Laos and northeastern Cambodia". 

These findings pose an immediate threat. The development of new anti-malarial medications is underway, but these medications are not likely to become available on the market for at least another few years. Malaria experts describe artemisinin as the best anti-malarial drug to date. 

The spread of drug-resistant malaria is threatening to undo all the advances made against the deadly parasite. If this continues, millions of people could be at risk — particularly babies, pregnant women, and people with compromised immune systems. 

Professor Nicholas White from the University of Oxford described the situation as "worse than expected" and warned that we need to take "radical action and make this a global public health priority, without delay". Professor White noted that the study showed that longer courses of treatment were still effective. The undeniable warning signs show that drug-resistant malaria will spread quickly if nothing is done to stop it. As effective treatment depends more and more on the other drugs used in the cocktail to treat malaria, the malaria parasite is likely to develop resistance to those other drugs as well.

What might this "radical action" consist of? Professor white notes that containment hasn't been very effective thus far. He proposes "all-out assault on falciparum malaria, to eliminate it before it can no longer be treated effectively". This war on malaria would involve administering drugs to everyone — infected or not — in the artemisinin-resistant areas. 

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