Resisting Resistance: What's Next in the Fight Against Malaria?

The end may be near for what has long been the current front-line malaria treatment. What's next?


It's been described as a crisis in the anti-malaria community. Resistance to ACTs (artemisinin-based combination therapies), the oft-described super drug in efforts to combat malaria, have reached a tipping point.

The most deadly malaria parasite, Plasmodium Falciparum, has for years been altering its genetics in response to the drug. The resistance, first reported at the border of Thailand and Cambodia, has led many researchers to believe that it will spread into India, Bangladesh and eventually make its way to Africa.

Consider this: Malaria killed an estimated 584,000 people in 2013 and one in seven of us carry the parasite.

Professor François Nosten, Director of the Shoklo Malaria Research Unit, has spent his career in Mae Sot, Thailand, the border area considered ground zero in this fight. If resistance continues, as it likely will, and if powerful new drugs are not able to counter the decline of ACTs, Professor Nosten fears malaria-related deaths could dramatically rise.

"If resistance to artemisinin and partner drugs develop further we will see a rise in the number of malaria cases," Francois began. "This will translate to higher numbers of severe malaria and in more deaths. In Southeast Asia this could take the form of devastating epidemics and in Africa we could return to the 90s, when chloroquine was ineffective but used, resulting in millions of deaths."

So what's the alternative? Is there a promising new drug or combination of drugs on the horizon? I asked Professor Nicholas Day, Director of the Mahidol Oxford Tropical Medicine Research Unit in Thailand. Here's his response:

This article was supported with funding from the International Reporting Project.

 -Photo: James Gathany, Content Provider: CDC [Public domain], via Wikimedia Commons

An earlier version of this post stated that resistance was first reported at the border of Thailand and Burma, when actually it was first reported at the border of Thailand and Cambodia.