Judges' Special Recognition
"Malaria: blood,sweat, and tears"
Dr. Rupam Tripra
Mahidol-Oxford Tropical Medical Research Unit
"There was increased concern that the parasite was not clearing, and this research facility was created to examine the issue. The results are clear: day-by-day resistance is undeniably growing. Artemisinin is quickly losing its ability to work here. The dangers associated with this emerging resistance can't be overstated. The numbers behind me are the data of individuals who have had resistant malaria."
The malaria parasite's ability to develop drug resistance is a major problem in the fight against the disease. One obvious solution to drug resistance is, of course, newer and better drugs. Unfortunately, each new generation of drugs is many times more expensive than the last. Artemisinin-based Combination Therapy (ACT), the current drugs of choice, are twenty times more expensive than chloroquine, a previously used anti-malarial drug that is no longer sufficiently effective against Plasmodium falciparum malaria. There is already an emerging artemisinin resistant strain in South East Asia. It is believed that if this strain were to emerge in Africa, the death toll could be astronomical.
Although resistance occurs naturally, as a result of evolution, there are also numerous contributing human factors. When patients do not complete their drug therapy regimen, either through inability to pay for a full dose or lack of understanding of the importance of following the dosage instructions, the effect is the same.
Human greed is also a factor. Many ineffectual counterfeit and sub-standard drugs are sold to unsuspecting patients. This allows the malaria parasite to develop resistance to the active ingredient in the medication while, at the same time, failing to cure the patient.
The economic cost and personal suffering caused by resistant strains of malaria are enormous. Millions have died as a result. Resistant malaria has made affordable medication unattainable for entire socio-economic groups. Increased efforts to monitor drug resistance and efficacy are essential. By doing so, new drug treatment policies based on current data can be implemented more quickly, thus preventing higher treatment failure rates and deaths from drug-resistant strains.