Den nye farlige sygdomskæmpe er modstandsdygtige stammer af malaria, som ikke kan behandles med dagens medikamenter – de findes allerede på grænsen mellem Thailand og Cambodja og verden bør ruste sig til nye holmgange trods ti års bemærkelsesværdige resultater.
LONDON, 3 March 2014 (IRIN): A lot can change in a decade. Back in 2003, many countries still relied on the increasingly ineffective chloroquine (klorokin) to treat malaria.
Malaria testing was a job for lab technicians with microscopes, and treatment was left to professionals. And public health officials were smarting from their failure to eradicate the disease in the 1950s and 60s.
Ten years later, the field looks very different, in large part because ample (rigelig) funding is now available, from the Global Fund, the President’s Malaria Initiative (a US government programme) and the Bill and Melinda Gates Foundation.
* Artemisinin-based combination therapies (ACTs) have replaced chloroquine, proving reliable and effective.
* Rapid diagnostic tests have brought testing and treatment down to the community level.
* Many millions of bed nets have been distributed and
* Elimination of the disease is back on the agenda.
“The news is exceptionally good,” said Desmond Chavasse, who is responsible for the malaria and child survival programme at Population Services International, adding:
“We have a one-third reduction in incidence and a halving of malaria child mortality since 2000. In sub-Saharan Africa, about 42 percent of people now have access to treated mosquito nets, so some really fantastic progress there.”
The dark side
But there has been one serious change for the worse.
ACTs – which have underpinned this success – have stopped working in areas around the Thailand-Cambodia border, an area where drug resistance often first appears.
So far, the resistant strains (modstandsdygtige sygdomsstammer) have been contained, but Chavasse warns that the recent successes are “exceptionally fragile”.
“Resistance will get us in the end, whether it is insecticide or drug resistance, so we need an elimination goal, and that means we have to do different things, we can not just do more of the same”, he said.
Chavasse was speaking in London to mark 10 years of work by the Malaria Consortium, which was founded in 2003 by teams from the London and Liverpool schools of tropical medicine.
At the half-day meeting, debate focused on some of the issues that remain unresolved today:
* the proper use of volunteers to diagnose and treat malaria in the community,
* the best way to work with the private sector, and
* concerns surrounding drug resistance and elimination.
A thankless job
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http://www.irinnews.org/report/99727/malaria-fight-sees-decade-of-progress-with-pitfalls-ahead
