As the Shoklo Malaria Research Unit (SMRU) in Mae Sot, Thailand, which borders Burma, celebrates its twentieth anniversary, its Director, Professor François Nosten, is able to reflect on the success of the unit, which is based amongst the region's refugee camps. The currently recommended malaria therapies (based on drug combinations including an artemisinin derivative) are the result of research carried out at SMRU, which is part of the Wellcome Trust's Major Overseas Programme in Thailand. Professor Nosten is amongst the top ten most-cited researchers in malaria research and has been a key player in the fight against drug-resistant strains of the parasite.
Opening in 1986 at Nosten's home, the research unit moved to Shoklo in 1989, the largest of the refugee camps on the border of Thailand and Burma, where 9,000 Karen refugees from across the border were housed. The focus of the research was to study the efficacy of malaria drug treatments in pregnant women and in children.
The unit was forced to move to its current location in Mae Sot in 1996 one year after an attack by guerrillas from the Democratic Karen Buddhist Army, targeting foreign aid workers in an attempt to force the refugees to return to Burma. During the attack, Professor Nosten and his colleague Rose McGready had been forced to hide in the jungle.
Now, Professor Nosten is assisted in his work by Thai nationals from the region, including a number of local Karen and Burmese who received training by the SMRU team. In addition to studying malaria drug treatments for pregnant women, the unit has carri ed out crucial research into artemisinin combination therapies (ACTs) aimed at combating the rapid rise in drug-resistance. The unit has carried out the largest number of drug trials in malaria and research at the unit has been influential in changing WHO guidelines for malaria drug treatment.
The reduction in the number of malaria cases has allowed the unit to focus on other health issues such as respiratory diseases. In addition, a surveillance network established in 1995 to monitor malaria infection in the camps along the border has now received funding to track the development of the avian influenza virus.