WHO Sees Gains in Malaria Fight but Concerns Remain

Health authorities, led by the World Health Organization, are making progress against drug-resistant strains of malaria in the border regions of Thailand. WHO officials say efforts to curb the emergence of resistant strains in Burma, however, are critical to preventing the disease from spreading into South Asia.

The World Health Organization (WHO) says malaria threatens 2.2 billion people in 20 countries across the Asia Pacific region. In 2010 there were 28 million cases reported and 38,000 lives lost - a death toll exceeded only in Sub-Saharan Africa.

More than 90 percent of the deaths were in India, Burma, Bangladesh, Indonesia and Papua New Guinea. Worldwide, the mosquito-borne disease affects some 260 million people and kills around 650,000 of them every year.

In recent years, health authorities have come to rely on a combination of therapies based on the artemisinin drug for treating malaria.

Dr. Pascal Ringwald, coordinator of WHO’s drug resistance and containment unit, said progress has been made in the Mekong Region, especially in treating cases involving the deadly parasite ‘falciparium.’ But he said the gains remain fragile.

“Paradoxically - and this is the good news - the numbers of falciparium cases is going down, drastically down. This is not only due to the containment activities but it is also because we have better tools, we have combination therapy and the countries have better malaria control activities,” said Ringwald.

WHO says health authorities are moving to a stage of completely eliminating malaria in Bhutan, North Korea, Nepal and Sri Lanka. Deaths from the disease have declined markedly in Bangladesh and Thailand, and gains are being recorded in India, Indonesia, Burma and East Timor.

But an emerging threat has come with the growing incidence of drug-resistant malaria strains, especially in Cambodia, Thailand, Vietnam and Burma. Ringwald said the challenge is to maintain a political commitment to the fight against malaria.

“One of the problems is when countries are reducing the malaria burden, malaria it is seen as no longer a priority. So we need in areas where artemisinin resistance has emerged most often the transmission of the malaria is very low, and what we need to keep is the awareness and political commitment that malaria is not a neglected disease,” said Ringwald.

Drug-resistant forms of malaria have emerged in border regions of Thailand and Cambodia, and between Thailand and Burma. Scientists blame the use of single-use drugs and sales of fake drugs for the resistance. WHO says Cambodia is making efforts to crack down on the sales of fake drugs.

WHO says the main concern lies in Burma where 40 million people, or 69 percent of the population, live in malaria-endemic areas. In 2010 Burma officially reported 650,000 malaria cases and 788 fatalities, though drug combinations are effective in more than 95 percent of the country's cases.

WHO is watching closely for any sign of the drug-resistant strains spreading into South Asia, and Ringwald said the goal is to contain the strains in the areas where they now exist.

Ringwald said Africa also needs to strengthen its malaria control to avoid the emergence of the same kinds of strains now evident in Southeast Asia.