There were about 216 million cases of malaria last year and an estimated 655,000 deaths in 2010 according to the World Malaria Report 2011. Most deaths occur among children in Africa where a child dies every minute from malaria. Resistance to treatment adds to these statistics.
Resistance to artemisinin - a vital component of drugs used to combat the most severe form of malaria - has been reported in a number of countries in Southeast Asia, including Cambodia and Thailand, says the WHO, which authored the report. In September, it was reported that resistant areas may now include central Vietnam and southeastern Myanmar.
Nick White, professor of tropical medicine at Mahidol University in Thailand, and the University of Oxford, confirms that "resistance is spreading, but it is not clear how far". Observations suggest that although there are changes in parasite sensitivity to artemisinin, artemisinin-based combination therapy (ACT) remains clinically effective for the treatment of Plasmodium falciparum malaria, the most deadly and one of the most common strains.
Since 1994, ACTs have been saving millions of lives in the developing world. While 90 per cent of malarial deaths occur in sub-Saharan Africa, the disease occurs in more than 100 countries, with more than 200 million clinical cases per year. Children under five, and pregnant women, are most at risk.
Experts agree that without global resistance containment efforts, including an increase in funding and research, recent progress in malaria control could be threatened. Last year, there was a shortfall of approximately US$4 billion needed to fully control malaria and contain artemisinin resistance. This urgency is heightened by the fact that there is nothing in the pipeline, nor are there any alternatives that could offer the same level of efficacy as ACTs.
White believes there is much talk about the importance of funding research efforts related to resistance containment, "but there is no clear commitment from international donors".