Ed Yong, writing for the new Wellcome Trust-sponsored science publication, Mosaic, has gone to Thailand to follow the development of artemisin-resistant malaria: “How malaria defeats our drugs”.
Nosten thinks that without radical measures, resistance will spread to India and Bangladesh. Once that happens, it will be too late. Those countries are too big, too populous, too uneven in their health services to even dream about containing the resistant parasites. Once there, they will inevitably spread further. He thinks it will happen in three years, maybe four. “Look at the speed of change on this border. It’s exponential. It’s not going to take 10 or 15 years to reach Bangladesh. It’ll take just a few. We have to do something before it’s too late.” Hundreds of scientists are developing innovative new ways of dealing with malaria, from potential vaccines to new drugs, genetically modified mosquitoes to lethal fungi. As Nosten sees it, none of these will be ready in time. The only way of stopping artemisinin resistance, he says, is to completely remove malaria from its cradle of resistance. “If you want to eliminate artemisinin resistance, you have to eliminate malaria,” says Nosten. Not control it, not contain it. Eliminate it.
The article has a fascinating story about the work of a physician and a researcher, both with years of experience in Southeast Asia fighting malaria outbreaks.
One of my video lectures is titled, “Everything I know about human genetics I learned from malaria”, reflecting the importance of the parasite in human evolution. As I read this article, I wondered about other aspects of human-malaria interactions not covered by artemesin resistance, especially the importance of the hemoglobin E variant in this part of the world.