Martin de Smet , leader of the Médecins Sans Frontières malaria working group, has published a letter in the New Scientist claiming malaria is developing alarming resistance to artemisinins, especially in Cambodia, and that the world needs to pay closer attention to this situation.
Artemisinins are the preferred treatment for malaria and are both effective and well tolerated in patients. However, the World health Organization is now recommending combination therapies that include artemisinins since there have been other recent reports of resistance.
Smet says "In many countries during transmission season, anyone presenting to a clinic with fever is treated as a malaria patient. In fact no more than 70 per cent of these patients will have malaria, and sometimes as few as 30 per cent. The millions treated unnecessarily are a potential source of resistance: if they become infected shortly after treatment, the malaria parasite is exposed to sub-therapeutic doses of drugs still in the bloodstream, which allows resistance to develop. Use of rapid diagnostic tests or microscopy to confirm malaria is therefore imperative."
"We must remove all barriers to malaria healthcare everywhere, or risk losing the only effective drug to treat a disease that still kills a child every 30 seconds. There is no excuse not to act."