Is Artemisinin Losing Its Magic in Africa?

A new study from Uganda adds to long-brewing fears that drug-resistance malaria is gaining a foothold in Africa, the AP reports.
In a 3-year study, published yesterday in the New England Journal of Medicine, researchers found that by 2019, nearly 20% of 240 samples collected from patients treated with artemisinin showed genetic mutations associated with resistance to the key drug. The patients were able to clear the malaria-causing parasites, but it took much longer.
The Uganda findings follow evidence of partial resistance to artemisinin in Rwanda, documented in a study published in April in The Lancet Infectious Diseases.

Drug-evading parasites appeared in Southeast Asia in the early 2000s, eventually leading to failures of frontline therapies. But the stakes are higher for Africa, home to 94% of both malaria cases and deaths worldwide in 2019, Science notes.

So what next? “We shouldn’t wait until the fire is burning to do something, but that is not what generally happens in global health,” Nicholas White, a tropical medicine professor at Mahidol University in Bangkok who wrote a companion NEJM editorial, told the AP. He suggests:

  • Replacing the current standard 2-punch approach—pairing artemisinin with another drug—with a 3-drug combo.
  • Beefing up surveillance
  • Supporting research into new drugs

China eliminated malaria. Could it be a model for the rest of the world? – South China Morning Post

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