Multidrug-Resistant Malaria Erupts in Southeast Asia
Dr. Alexander Fleming’s discovery of penicillin, the world’s first antibiotic, earned him the Nobel Prize in Physiology or Medicine and revolutionized the course of modern medicine. However, in his acceptance speech, Fleming possessed the foresight to warn against the detrimental effects of penicillin overuse.
As predicted, bacterial resistance today has become a pressing issue due to the over-prescription of antibiotics which causes tens of thousands of deaths annually. Southeast Asia has seen a recent surge in a new strain of multidrug-resistant malaria known as Plasmodium falciparum, particularly in western Cambodia, northeastern Thailand, Laos, and southern Vietnam.
This isn’t the first time malaria has shown resistance to treatment. When a parasite in Southeast Asia developed resistance to chloroquine during the 1980s, it quickly reproduced and spread to Africa, killing millions.
Leaders at the World Health Organization, however, believe the chances of a repeat incident are low because Africa is better prepared to handle these situations than it was in the past. Still, the risk of an outbreak “cannot be discounted.”
P. falciparum is immune to the antimalarial drugs artemisinin and piperaquine. Microbes generally can’t become resistant if two drugs are administered simultaneously, so the initial combination treatments were quite effective. That is, until a strain of artemisinin resistant malaria also developed resistance to piperaquine.
Meanwhile, a fresh outbreak of chloroquine resistant P. falciparum in India is forcing Kolkata doctors to switch to artemisinin treatments. Debashish Saha, a senior consultant from AMRI Hospital, stated that “It could be dangerous to use chloroquine since… the treatment may turn ineffective.” Even then, “[artemisinin] needs to be used judiciously,” he added.
Cambodia and Vietnam have already transitioned to combination therapies using mefloquine in place of piperaquine. But Arjen Dondorp, a scientist from the Mahidol Oxford Tropical Medicine Research Unit, predicts that it is only a matter of time before “mefloquine resistance emerges,” raising the prospect of untreatable malaria.
Despite the technological and medical advances made by the modern world in the fight against disease, our current lead might be smaller and less stable than we think.