Dr Shin launches emergency response to antimalarial drug resistance

WHO Regional Director for the Western Pacific Dr Shin Young-soo with Princess Astrid of Belgium (middle) and Cambodia Health Minister Dr Mam Bun Heng (far left) observe a village malaria worker preparing a malaria patient for a rapid diagnostic test in Kampong Speu province's Chambok Village.

The emergence in the Greater Mekong Subregion of resistance to artemisinin, the frontline drug against malaria, poses a serious potential threat to global health, WHO Regional Director for the Western Pacific Dr Shin Young-soo warned here on World Malaria Day.

Dr Shin spoke at the launch of WHO's "Emergency Response to Artemisinin Response in the Greater Mekong Subregion" (ERAR) framework— a cross-border, multi-pronged initiative designed to provide the six countries of the Subregion with the strategic direction to beat resistance to artemisinin.

Artemisinin-resistant falciparum malaria has emerged in Cambodia, Myanmar, Thailand and Viet Nam, setting off fears that it could appear elsewhere, particularly in Africa, which has the world's biggest malaria problem and where it would have incalculable consequences.

The WHO emergency response, which is scheduled to run for three years, receives support from the Bill & Melinda Gates Foundation and AusAID. The Global Fund is already making available considerable funding to country programmes in Cambodia and Thailand for this purpose, and has set aside another US $100 million for a regional initiative. Other development partners are also supporting countries. "We are extremely grateful to all our partners for their financial and technical support," Dr Shin said.

A regional hub was set up in the Cambodian capital on World Malaria Day (25 April) to provide coordination and support for the intensified containment and preventive measures set out in the framework, with staff throughout the Greater Mekong Subregion countries.

Dr Shin told an audience of regional malaria experts and development partners: "Failure to contain resistance to artemisinin in this part of the world may have tragic consequences globally. Make no mistake—the world is watching. And we cannot afford to fail."

Artemisinin-based combination therapies (ACTs) are the most effective treatment for uncomplicated falciparum malaria in most endemic countries and have been central to the success in recent years in global malaria prevention and control.

WHO says that one of the keys to prevent resistance to artemisinin is to halt the use of oral artemisinin-based monotherapies. When treated with artemisinin alone, without a partner drug, patients may discontinue treatment prematurely following the rapid disappearance of malaria symptoms. This can contribute to the development of resistance.

Dr Shin said: "We in the health sector like to think we are close to beating malaria. But the truth is that malaria will beat us all, unless we do more than we are doing now—and do it better."

The Regional Director called for the pooling of skills of all the organizations and partners working in fields related to malaria control. "Our approach must start with solid commitments and coordination from sectors outside of health," he said. "This will require support at the very highest level of government, to bring together all the parties that deal with complex issues—such as how to reach out to migrants and other hard-to-reach populations.

Also speaking at the launch, Cambodian Health Minister Dr Mam Bun Heng said Cambodia had made significant progress against malaria, but warned that the emergence of resistance to artemisinin, especially in border areas, presented a serious challenge. Dr Mam described the launching of the emergency response as a "historical moment".

The Greater Mekong Subregion is made up of Cambodia, China's Guangxi Zhuang Autonomous Region and Yunnan province, the Lao People's Democratic Republic, Myanmar, Thailand and Viet Nam.

Earlier that day, Dr Shin attended World Malaria Day celebrations in Chambok village, Kampong Speu province.

“As one of the 10 malaria-endemic countries in the Western Pacific Region, Cambodia has made significant progress over the past few decades,” Dr Shin told the audience, which included Princess Astrid of Belgium, the Special Representative of the Roll Back Malaria Partnership. “Cambodia reduced malaria deaths by 86% in 2011 from the 2000 baseline—far beyond the 75% target set by the World Health Assembly in 2005.”

Dr Shin also acknowledged the role played by local malaria workers in the frontline battle against malaria.

“I am particularly impressed by the role of village malaria workers in providing malaria testing and treatment," he said while watching a village volunteer carry out a test procedure with Health Minister Mam and Princess Astrid.

For more information, please contact:

Dr Eva-Maria Christophel
Team Leader, Malaria other Vectorborne and Parasitic Diseases
Tel: +632 528 9725
E-mail: christophele@wpro.who.int

Mr Sonny Inbaraj Krishnan
Communications and Media Relations Officer
WHO Cambodia
Tel: +85577359027
E-mail: sonny.inbaraj@gmail.com

Mr Timothy O’Leary
Public Information Officer
Tel: +632 528 9992
E-mail: olearyt@wpro.who.int