January 2009

Drug Resistance and Global Health Update January 2009*

* Please excuse the late delivery of this e-update. The January holidays interrupted our normal schedule.


Dear Colleague,

Warm wishes for 2009 from all of us here at CGD’s Drug Resistance Working Group!

Malaria transmission has declined in parts of sub-Saharan Africa. Access to rapid diagnostic tests is increasing. Is it time for a malaria policy change? Should presumptive treatment of fever with anti-malarials no longer be the norm? PLoS Medicine is hosting a debate on these questions, with B Genton et al. arguing in favor of policy change and English et al. taking the opposite stance.

In lieu of a guest column this month, we have prepared a blog on this topic. With clear policy implications, Alix Beith, Scott Kniaz and I have tried to outline the main points in this timely debate. What are your thoughts on this important issue and how do the arguments stand up in the face of drug resistance? Please read the blog below and respond in the comments section.

As always, we welcome your thoughts at [email protected].

Regards,

Rachel Nugent
Deputy Director for Global Health
Center for Global Development

Is it Time to Change Malaria Treatment Policy? The Argument from a Resistance Perspective

By Rachel Nugent, with support from Alix Beith and Scott Kniaz

I am finding it hard to choose a side on the recent malaria treatment policy debate. It is clear that current anti-malarial treatment policy which dictates that, in high-transmission settings, children under five that have a fever are given anti-malarials is certainly not optimal. Children with fevers not caused by malaria may suffer side-effects from taking unnecessary anti-malarial drugs and are also not being treated for what ails them. Additionally, excessive use of anti-malarials drives emergence of drug-resistant strains of the malaria parasite, which can then be transmitted to the larger community.

Malaria drug resistance is a world-wide problem. All over the globe, once extremely effective drugs like chloroquine can no longer get the job done, with resistance levels as high as 80% in Latin America. In fact, the deadliest malaria parasite, P. falciparum, has shown resistance to all treatments except artemisinin. However, there are worrying signs that tolerance to artemisinin may be developing in some areas, specifically along the Thai-Cambodian border. Once (and it is “once”, not “if”) artemisinin-resistance emerges and spreads, we will have no silver or even bronze bullets (at least for now) for the fight against malaria.

READ MORE

IN THE NEWS

Bacteria (besides TB)

TB

Malaria

HIV

Other

Featured VIDEO

  • How does antibiotic resistance develop? What are the development practices drug companies employ when producing antimicrobials? Click here to view the THIRD part of a three-part presentation/discussion given on September 18, 2008 at the Koshland Science Museum in Washington, D.C by Dr. Stuart Levy and Dr. Linda Tollefson

latest research

PARTNER RESOURCES

RECENT EVENTS

CALL FOR PAPERS

  • Southern Med Review (published quarterly) is an international journal to promote and publish commentary and research on the rational use of and access to medicines. The Review is currently welcoming submissions for it's March issue (deadline 10 Feb.)
  • Round 3 of the Gates Grand Challenges in Global Health opens on March 31st, 2009. Click here for more information

RESISTANCE-RELATED JOBS

  • Postdoctoral positions available in the Viral Recombination Section of the HIV Drug Resistance Program, National Cancer Institute, National Institutes of Health, USA