Tackling antimalarial drug resistance in Southeast Asia

Between 2012 and 2018, the number of deaths from malaria in the Greater Mekong Subregion of Southeast Asia fell by 95%. However, there are concerns that drug-resistant malaria parasites in the region could spread into South Asia and to Africa, where the majority of the 400,000 global deaths from malaria occur each year.

In October 2020, the Academy of Medical Sciences held a virtual workshop with the Thai Academy of Science and Technology (TAST) and the Thai National Center for Genetic Engineering and Biotechnology, to assess the current state of malaria drug resistance and explore the role that research could play in addressing the challenge it poses to malaria elimination.

Today [Wednesday 10 March 2021], we have published a report from the workshop ‘Addressing the threat of antimalarial drug resistance to malaria elimination in Southeast Asia’, summarising challenges and areas where additional research is needed to deal with rising levels of antimalarial drug resistance, identified by the participants.

Key issues highlighted in the report include:

• Drug development: The number of new antimalarial drugs in the pipeline is low. Although at least two promising new drugs have a realistic prospect of being licensed, in the meantime, the efficacy of existing drugs must be preserved.
• Genetic markers of resistance: Further research is needed to identify emerging mutations associated with drug resistance, for currently used drugs as well as newly developed drugs as they are evaluated in clinical trials.
• Malaria control: Recommended community-based strategies to detect and investigate new malaria cases are not appropriate in remote, hard-to-reach regions. Mass drug administration and/or mass screening and treatment may be a valuable alternative or complementary approaches.
• Communities: As malaria becomes less common, participants noted that it is important to maintain community commitment to elimination, support for control measures and adherence to treatment.
• Integration: It is increasingly important to integrate malaria control and other health services, which will contribute to the development of more patient-centred and sustainable services.
• ‘Final mile’: More research is needed to identify the most effective strategies for malaria control and elimination in areas of low transmission, particularly in environmentally challenging locations.

Workshop participants felt that rising levels of antimalarial drug resistance needed to be dealt with as a matter of urgency. They called for genomic surveillance information to be communicated effectively to national malaria control programmes and policymakers, to inform practical control efforts and to mobilise political commitment to malaria elimination.

As the malaria disease burden falls and other health priorities, including COVID-19, capture political and public health attention, it is essential that action is taken to prevent an epidemic of drug-resistant malaria.  

For more information, please download the full workshop report, which is available to the right of this page.

This workshop was funded by the Global Challenges Research Fund that aims to support cutting-edge research that addresses the challenges faced by developing countries. Visit our GCRF webpage to read more about the fund and further policy workshops.