Drug-resistant malaria on Myanmar-India border a risk to world health

In the parts of the world where malaria still rears its ugly head, the sometimes-deadly parasitic disease is mostly controlled and bested by a class of drugs called artemisinins. But a new study shows pockets of drug-resistant malarial outbreaks have been cropping up throughout Southeast Asia.
The study looked at blood samples of more than 940 people diagnosed with malaria at 55 healthcare sites across Myanmar, the Southeast Asian country also sometimes referred to as Burma. Nearly 40 percent of the samples showed a genetic mutation signaling a resistance to artemisinin. The disease, carried and delivered by mosquitos, is now threatening to spread into East India.
"[Burma] is considered the front line in the battle against artemisinin resistance as it forms a gateway for resistance to spread to the rest of the world," lead study author Charles Woodrow, a researcher at the Mahidol-Oxford Tropical Medicine Research Unit in Bangkok, told The Guardian.
The new study, which also noted drug-resistant infections in Cambodia, Laos, Thailand and Vietnam, was published this week in the Lancet Infectious Diseases journal.
"If this were to spread into India, malaria will continue to affect rural populations there, but there may not be an immediate effect on cure-rate," Woodrow told the BBC. "But beyond the short term, there is very likely to be a problem, and there are very few [other] drugs on the table."
Woodrow and his colleagues also worry that the drug-resistant strain could make the jump to Africa, or emerge there independently as it has before. Some 90 percent of a malaria deaths occur in Africa. In 2013, more 525,000 Africans died from the disease -- the vast majority of them children.
The current problem, researchers say, harkens back to a time when chloroquine was the drug of choice for treating and preventing malaria. But resistance to the chloroquine emerged in malarial strains in Cambodia and Thailand in 1957. Over the following 17 years, the drug-resistant strain spread around the world, resulting in an uptick in malarial infections and deaths.
"The pace at which the geographical extent of artemisinin resistance is spreading is faster than the rate at which control and elimination measures are being developed and instituted, or new drugs being introduced," scientists wrote in the new study. "A vigorous international effort to contain this enormous threat is needed."