TIME reports on evidence along the Thai-Cambodia border that the malaria parasite is gaining resistance to artemisinin â€“ “the only remaining effective drug in the world’s arsenal against malaria’s most deadly strain.”
In a session at the 5th Multilateral Initiative on Malaria (MIM) Pan-African Conference in Nairobi, Kenya, experts discussed the tools required to eradicate the disease and highlighted insecticide and drug resistance in some parts of the world, Xinhua reports.
“Researchers who tested a novel type of antibiotic against multi-drug-resistant tuberculosis [MDR-TB] are reporting that nearly half of patients who got the new drug cleared the bacteria from their lung fluid in two months,” according to a study published Thursday in the New England Journal of Medicine, Reuters reports. Japanese pharmaceutical company Otsuka developed the experimental drug, delamanid, and “also designed and financed the clinical trial, which took place in 17 medical centers across nine countries,” the news service writes (Emery, 6/6).
The Wall Street Journal reports on a rise of multi-drug resistant tuberculosis (TB) in India, writing, “India’s slow response to years of medical warnings now threatens to turn the country into an incubator for a mutant strain of tuberculosis that is proving resistant to all known treatments, raising alarms of a new global health hazard.” The newspaper continues, “Spread of the strain could return tuberculosis to the fatal plague that killed two-thirds of people afflicted, before modern treatments were developed in the 1940s, said Dr. Mario Raviglione, director of the Stop TB Department of the World Health Organization.” The newspaper notes, “The WHO is now assisting India to combat the strain” (Anand, 6/19).
In a study published on Wednesday in the Lancet, researchers from the Centers for Disease Control and Prevention found that “[a]mong 1,278 patients who were resistant to two or more first-line tuberculosis drugs in Estonia, Latvia, Peru, Philippines, Russia, South Africa, South Korea and Thailand, 43.7 percent showed resistance to at least one second-line drug,” which “suggest[s] the deadly disease may become ‘virtually untreatable,’” according to the study, Bloomberg Businessweek reports (Kitamura/Narayan, 8/29). “In about a fifth of cases, they found resistance to at least one second-line injectable [versus oral] drug,” according to Reuters, which states “[t]his ranged from two percent in the Philippines to 47 percent in Latvia.” Overall, 6.7 percent of patients had extensively drug-resistant TB (XDR-TB), meaning patients are resistant to the first-line drugs isoniazid and rifampicin as well as drugs in the fluoroquinolone antibiotic class and a second-line injectable antibiotic, Reuters adds, noting “[r]ates in South Korea, at 15.2 percent, and Russia at 11.3 percent, were more than twice the WHO’s global estimate of 5.4 percent at that time” (Kelland, 8/30).
The Washington Post examines how the “discovery of an almost untreatable form of tuberculosis [TB] in India has set off alarm bells around the world and helped spur a dramatic expansion of government efforts to battle the killer lung disease.” The newspaper writes, “For the past decade, a nationwide tuberculosis program involving millions of health workers and volunteers has made slow but significant progress in battling the disease in India and has been hailed as a public health success story,” but “any sense of complacency was dispelled in December when a doctor in Mumbai, Zarir Udwadia, discovered a strain of the disease that did not respond to any of the 12 frontline drugs.”
“The World Health Organization said Thursday that governments in the Mekong region must act ‘urgently’ to stop the spread of drug-resistant malaria which has emerged in parts of Vietnam and Myanmar,” Agence France-Presse reports. “There is growing evidence that the malaria parasite is becoming resistant to a frontline treatment, the anti-malarial drug artemisinin, in southern and central Vietnam and in southeastern Myanmar, the WHO said in a statement,” AFP writes, noting, “WHO regional director, Shin Young-soo, said countries must ‘urgently address this issue before we put at risk not only the fragile gains we have made in malaria control but also our goal of a malaria-free Western Pacific Region.’” The news service adds, “Countries in the Mekong region must “intensify and expand” operations to contain and eliminate artemisinin-resistant malaria, Shin said at a WHO regional meeting in Hanoi” (9/28).
“[O]ver the past month, [tuberculosis (TB)] has captured high-profile attention from the Washington Post, the New York Times, TIME, NPR, [Agence France-Presse] and other major media, generating big headlines about the rising challenge we face in tackling one of humanity’s oldest and most resilient infectious diseases,” Jan Gheuens, interim director of the Bill & Melinda Gates Foundation’s TB Program, writes in the foundation’s “Impatient Optimists” blog. “Why should we be concerned?” he asks. Gheuens says because the worldwide number of multidrug-resistant TB (MDR-TB) cases is growing; “it costs a lot of money to treat MDR-TB”; and “MDR-TB patients must go through two years of intensive treatment, including daily injections for the first six months.” He concludes, “What’s clear now, more than ever, is that making progress on TB will require a comprehensive approach that includes new and better approaches to diagnosis, treatment, and prevention” (9/6).
The U.S. Government Accountability Office (GAO) recently released two reports on issues related to global health. In “Ensuring Drug Quality in Global Health Programs,” the agency writes, “Concerns have been raised about the potential for substandard drugs to enter the supply chains of global health programs,” and notes that it concluded, “U.S.-funded global health programs have put regulatory and policy requirements in place to help prevent procurement of substandard drugs” (8/1). In another report looking at the WHO, titled “Reform Agenda Developed, but U.S. Actions to Monitor Progress Could be Enhanced,” GAO found, “The United States has provided input into WHO’s reform agenda, particularly in the areas of transparency and accountability, but the Department of State’s (State) tool for assessing progress in the area of management reform could be enhanced” (7/23).
“A third of the world’s population is carrying tuberculosis [TB], and the disease could become incurable if governments fail to act, the World Health Organization (WHO) has warned,” noting that a “[l]ack of funding for public health programs, the sale of inaccurate blood tests and the misuse of drugs, particularly in the private health sector, are hampering the fight against the disease and leading to drug resistance,” the Independent reports. “The rate of TB deaths had declined dramatically — by 40 percent between 1990 and 2000 — after a worldwide health campaign, which was particularly successful in China,” but “the emergence of drug-resistant strains threatens to halt progress and jeopardizes the WHO’s goal of eradicating the disease as a public health problem by 2050,” the newspaper writes, noting, “Two billion people are carriers of the TB bacillus” globally.