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Resistance management

Copyright Malaria ConsortiumMalaria Consortium has focused on strengthening monitoring, evaluation and surveillance systems to support efforts to control emerging resistance to artemisinin in Southeast Asia – particularly among vulnerable and hard-to-reach populations. We have a strong record of implementing successful projects across the region and are recognised as being among the foremost experts on the development of resistance response strategies in the region, demonstrated by our Technical Director’s role on the WHO Malaria Policy Advisory Committee and WHO’s Technical Expert Group for Antimalarial Drug Resistance and Containment.

Drug resistance

Copyright Malaria Consortium/Adam NadelParasite resistance to malaria treatments is not a recent occurrence; it first appeared in the 1970s and 1980 when the antimalarial medicines of the time began to lose their effectiveness. Artemisinin based combination therapies (ACTs) are now the most effective drugs, but face similar challenges as resistance re-emerges in Southeast Asia. Preventing the spread of antimalarial drug resistance in Southeast Asia – and the development of resistance in other parts of Asia, Africa and beyond – is a global public health priority. Malaria Consortium supports continuous monitoring of drug resistance in malaria-endemic countries along with research into the various contributing factors, enabling health authorities and practitioners to control the spread of drug resistance more effectively.

Malaria Consortium is also working to prevent the development of antibiotic resistance by focusing on improving diagnostic and treatment services for suspected pneumonia – the largest killer of children under five in sub Saharan Africa. Our recent study in Zambia through COMDIS-HSD, a research partnership funded by the UK government, sought to explore how antibiotics are used at the community level to treat suspected pneumonia and prevent the spread of resistance.

Insecticide resistance

Copyright Malaria ConsortiumInsecticide resistance is a growing problem in parts of Africa. There are 12 insecticides recommended for use in indoor residual spraying (IRS), with only pyrethroids currently used in long-lasting insecticidal nets.  However, there is evidence of insecticide resistance among major malaria vectors in various parts of Africa. If a mosquito develops resistance to one insecticide, in most cases it is immediately resistant to all other insecticides in the same class, which is increasingly limiting the available options for IRS. Resistance against pyrethroids is a particular cause for concern as no other insecticide class in our present armoury can be used for nets. Our recent research into the impact of pyrethroid resistance by mosquitoes has revealed some interesting results, however, indicating that the insecticides may still be working, albeit in an unexpected way.

Malaria Consortium is carrying out research on the distribution, impact and management of insecticide resistance and is a key player in shaping the view of the malaria community on the steps needed to address this challenge. We are also working on the implementation of effective interventions in close partnership with health services in endemic countries and global and local organisations involved in malaria control.

 

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