Asian Malaria Endgame Threatened by Resistance to Insecticides and Malaria Treatments
Asian experts surveyed in a new report fear that the last mile in malaria elimination in the region is threatened by increasing resistance to antimalarials and insecticides – new tools will be needed to defeat the disease.
BANGKOK, April 23, 2018 /3BL Media/– Asian malaria experts surveyed in a new report are saying that new tools are needed as the disease is becoming resistant to existing prevention and therapy measures. They called for continued investment in R&D for new antimalarials and insecticides to achieve the World Health Organization’s 2030 elimination targets.
The Malaria Futures for Asia (MalaFAsia) report was launched today in Bangkok. It captures the views of malaria program directors, researchers and NGOs in Cambodia, India, Myanmar, Thailand and Vietnam on progress towards malaria elimination. The study was conducted by independent policy researchers and commissioned by Novartis, the company that launched the first fixed-dose artemisinin-based combination therapy (ACT) two decades ago. ACTs are the current gold standard treatment for malaria.
The report comes against a background of enormous progress, where the number of reported malaria cases per thousand population has fallen by over 60 per cent across the region since 20101. Nearly two-thirds of experts surveyed believe that the region is likely to meet its malaria elimination targets2 for P. falciparum malaria, the most severe form of the disease. However, a majority expressed skepticism that the P. vivax strain could be eliminated by 2030.
“This is the first time in many years that Asian policymakers and implementers on the ground have been asked about their views on progress, challenges and opportunities toward malaria elimination,” said Prof Yongyuth Yuthavong, former Deputy Prime Minister of Thailand and member of the RBM Partnership to End Malaria board, and co-chair of the study. “While most are confident about progress, some are perhaps too confident. Complacency is always a danger. I have spent a lifetime fighting malaria and know that this final stage toward elimination will be the toughest.”
Resistance to insecticides and to artemisinin-containing treatments is also a serious concern, and while some respondents believe it can be contained as the region progresses toward elimination, others are much less confident. Nearly all said support for R&D into new insecticides and malaria treatments was critical. Novartis is currently conducting clinical trials on new antimalarials in Thailand and Vietnam in case ACT resistance spreads.
The remaining pockets of malaria in South and Southeast Asia are primarily in hard-to-reach forested areas and among mobile and migrant populations, the experts said. These pockets are often in remote border areas, therefore tracking them and ensuring those at risk receive diagnosis, treatment and care is challenging.
As the region approaches elimination, many thought integration of malaria services into broader health systems will become necessary. However, respondents did express concerns that specialist skills – particularly in microscopy diagnosis – might be lost in this process.
“Developing comprehensive primary care systems is vital as the Asian region faces the rising epidemic of chronic disease,” said Dr. K. Srinath Reddy, President, Public Health Foundation of India, the other co-chair of the MalaFAsia study.” However, we must be careful to preserve the expertise needed to achieve malaria elimination.”
Novartis commissioned the MalaFA studies as part of a large two-year effort to understand the views of national and regional experts across Asia and Africa on progress and challenges toward malaria elimination.
Notes to editors
The Malaria Futures for Asia (MalaFAsia) study was commissioned by Novartis Social Business to help guide domestic and donor commitments toward malaria elimination in the face of increasing challenges. In total, 36 interviews were conducted in Cambodia, India, Myanmar, Thailand and Vietnam. The research was developed in consultation with the co-chairs, the Asia Pacific Leaders Malaria Alliance, the RBM Partnership to End Malaria, Malaria No More US, Malaria No More UK and the Malaria Consortium. The co-chairs for the study are Prof Yongyuth Yuthavong, former Deputy Prime Minister of Thailand and member of the RBM Partnership to End Malaria board, and Dr. K. Srinath Reddy, President, Public Health Foundation of India.
Download a copy of the MalaFAsia report: bit.ly/MalaFAsia-report
References
- WHO, World Malaria Report 2018, p.41. Download full report from: www.who.int/malaria/publications/world-malaria-report-2018/en/
- The WHO Global Technical Strategy for Malaria 2016-2030 proposes targets, including reducing global deaths and caseload by at least 90%, and eliminating malaria in at least 35 countries by 2030. For more details, see: www.who.int/malaria/areas/global_targets/en/
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Janice Apilado |
Nadine Schecker |
Antonio Ligi |
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Asia Pacific Leaders Malaria Alliance, Singapore www.aplma.org |
Dr Ben Rolfe, Chief Executive Officer, APLMA: “We are very excited about the MalaFAsia report, which gives us a better understanding of perceptions in the region on progress and remaining challenges to reach malaria elimination. The combination of the Leaders' Dashboard generated every year by APLMA to track country progress and the MalaFAsia report, which provides views around bottlenecks, will give us unique insights into where countries stand in the fight against malaria and how the global malaria community can best support them.” |
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Malaria Consortium, London, UK www.malariaconsortium.org |
James Tibenderana, Head of Technical, Malaria Consortium: “This report highlights concerns around maintaining malaria treatment and diagnosis skills in low transmission contexts. An effective way of preserving and strengthening these skills is to train community and facility-based health workers on a broader range of childhood diseases, ensuring they remain active in communities and continue to support crucial malaria case monitoring and surveillance as countries move towards elimination”. |
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Malaria No More, Washington DC, US www.malarianomore.org |
“Ending malaria across South and Southeast Asia is within reach,” said Josh Blumenfeld, Managing Director for Global Policy and Advocacy, Malaria No More. “Through continued investments to combat rising drug and insecticide resistance, to meeting the needs of the most vulnerable and socially excluded in this region, particularly women and children, in the hardest to reach areas, to sustaining our political will and resource investments, we can ensure that no one dies from a mosquito bite.” |
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Malaria No More UK, London, UK www.malarianomore.org.uk |
James Whiting, Chief Executive Officer, Malaria No More UK: “This report highlights that despite successes in tackling malaria over the past decade, progress is not inevitable and it has been slowed by recent shortfalls in funding and increasing insecticide and drug resistance. If we are to achieve our goal of ending malaria for good, it is vital that we put the spotlight back on the disease, and focus national and global energy and resources on addressing the issues that threaten progress, both in Asia and beyond.” |
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Novartis Social Business, Basel, Switzerland socialbusiness.novartis.com
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Deborah Gildea, Head of Novartis Social Business, Asia: “Novartis is proud to support countries in this region in their drive to establish universal primary care. But we need to ensure that these new healthcare systems have the capacity to diagnose and treat malaria effectively while also addressing the rising incidence of chronic diseases. Countries in the region need to continue focusing on both, and ensure primary healthcare services are equipped to do so.” |
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RBM Partnership To End Malaria, Geneva, Switzerland endmalaria.org |
Prof Yongyuth Yuthavong, former Deputy Prime Minister of Thailand and member of the RBM Partnership to End Malaria board, and co-chair of the study: “This is the first time in many years that Asian policymakers and implementers on the ground have been asked about their views on progress, challenges and opportunities toward malaria elimination. While most are confident about progress, some are perhaps too confident. Complacency is always a danger. I have spent a lifetime fighting malaria and know that this final stage toward elimination will be the toughest. World Malaria Day is an opportunity to highlight commitments in the global fight to end malaria. We can achieve zero malaria within our lifetime. Join us and global partners this World Malaria Day by declaring “Zero Malaria Starts with Me” and committing to step up the fight to end this deadly disease.” |
