In South-East Asia, Plasmodium falciparum, one of the parasites that transmits malaria, developed resistance to the widely used antimalarial drug artemisinin over a decade ago. Now scientists have discovered that resistance is also starting to become more common in Africa.
A study published in the Lancet Infectious Diseases journal indicates that artemisinin-based combination therapies (ACTs) have not been able to clear malaria parasites from Rwandan children's blood in three days. The paper analysed 224 children with malaria aged six months to five years. In some areas, 15% of children still had detectable parasites after three days, which is the WHO criteria for partial resistance.
These findings raise serious concerns. Resistance to ACTs and insecticides against malaria vectors are among the most significant challenges to eradicate the disease worldwide. According to Prof Philip Rosenthal (University of California San Francisco), the continent is "on the verge of clinically meaningful artemisinin-resistance in Africa, as emerged in south-east Asia over a decade ago".
It will not be possible to achieve a malaria-free world without novel tools, such as gene drive. WHO has recognised the need for investing in research and innovation many times, including in the report "Malaria eradication: benefits, future scenarios & feasibility". Last year, WHO also openly supported research on genetically modified mosquitoes for the first time as an attempt to combat persisting vector-borne diseases, such as malaria and dengue.