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Artemisinin Resistance Threatens Efforts to Control Malaria
Date:11/19/2009

ified its artemisinin resistance containment activities since early 2007, when the resistance problem became apparent. A major objective of the containment project is to eliminate resistant parasites by detecting all malaria cases in target areas and ensuring effective treatment and parasite clearance. Another important objective is to prevent use of artemisinin monotherapy, fake drugs, and inappropriate treatment in the private sector. "Despite the proven effectiveness of combination therapy, the use of artemisinin monotherapy persists, undermining efforts to control recurrent infection and illness," Dr. Ringwald commented. "In addition, there are a number of counterfeit drugs on the market that contain few active ingredients."

Even when genuine artemisinin combination therapies are used, too often they are used to treat fever not due to malaria, further exacerbating the resistance problem. "It is critical to increase access to parasitologic diagnosis of malaria prior to treatment," commented Dr. Robert Newman, the recently appointed Director of the WHO Global Malaria Programme. "By treating all cases of fever as malaria, we not only overuse ACTs, but we also fail to provide appropriate care for the enormous number of individuals who have a non-malarial cause of their fever. In addition, it is not possible to implement an adequate malaria surveillance system without providing universal access to parasitologic diagnosis."

Dr. Ringwald expressed the hope that the ASTMH session would spur the international community to action. "We are very concerned about the possible emergence of new foci of malaria in Southeast Asia, where populations of the parasite may intersect with populations of hosts and vectors that support its existence," he said. "We hope the international community responds to our call to contain the artemisinin resistance problem in this region, and provides funding not only to support our containment activities, but also research
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SOURCE The American Society of Tropical Medicine and Hygiene
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