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Subscribe to RSSScientists are battling to stop a drug-resistant malaria that could threaten the lives of millions. "We worry that we are running out of time," one scientist says. NBC News' Ian Williams reports from northwestern Thailand.
MAE SOT, Thailand -- Clipboard in hand, Dr Francois Nosten worked his way down a ward of malaria patients. He stopped in front of five-year-old Ayemyint Than, who sat to attention and smiled. The smile told Nosten as much as his lines of graphs and figures.
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Ian Williams / NBC News
Ayemyint Than, 5, is being treated for malaria in northwestern Thailand.
"She's doing well," he said, moving to an older man, whose pale face and dull sunken eyes told a very different story. "Day five, and he's still positive?" he asked another of the doctors. "That's not very good. It means he was very slow to clear the parasite, no?"
To Nosten, it was further evidence of an alarming rise in resistance to artemisinin, currently the front-line drug in the treatment of malaria. He fears it could be the start of a global "nightmare" in which millions of people could lose their lives.
"We have to beat this resistance, win this race and eliminate the parasite before it’s too late. That's our challenge now," he said.
He said that artemisinin should take about 24 hours to deal with the parasite, but it was now taking three or four days in some cases. "We are going to see patients that don't respond to the treatment anymore,” he warned.
Nosten runs the Shoklo Malaria Research Unit, which is part of the Faculty of Tropical Medicine at Thailand's Mahidol University.
The unit has a string of clinics on both sides of the Moi River, which marks the porous border between Thailand and Myanmar.
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Ian Williams / NBC News
Migrants cross the Moi River, marking the border between Myanmar and Thailand.
Nosten set up the first one in 1986, since when there has been a steady fall in the total number of cases of malaria, but most recently a worrying emergence of drug resistance.
He first sounded the alarm in research published earlier this year, following the emergence of similar drug resistance along the Thai-Cambodia border.
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Nosten’s not sure whether the resistance he's found has spread from the Cambodia border or is home-grown. Either way, he's worried.
"It means that all the progress of the last 10 to 15 years will be lost," he warned. "Now the resistance is here, we worry that we are running out of time."
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Ian Williams / NBC News
Staff examine a baby who has been brought to the clinic with a fever, suspected to be malaria.
The malaria parasite -- carried by infected mosquitoes from person to person -- still kills an estimated 655,000 people a year.
That's almost 2,000 a day, mostly in Africa, with children being most at risk.
If the world loses its front-line drug, the impact could be devastating.
"The nightmare scenario is that the resistance will travel," Nosten said.
"We know what will happen in Africa when resistance is bad because we've been there before in the 1990s with chloroquine (another anti-malarial drug) … millions of deaths," he warned.
"We must prevent artemisinin resistance reaching Africa, but we also need to control it for the people in Asia - for their future."
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Ian Williams / NBC News
Dr Francois Nosten, right, consults staff as he meets malaria patients at a clinic near Mae Sot, Thailand.
Resistance to just about every major anti-malarial drug has started in the border regions that have been home to Nosten for more than 25 years.
Nobody knows exactly why, but poverty, conflict and large migrant and refugee populations constantly on the move all likely play a part. As do fake drugs or a failure to properly complete a course of treatment.
In the case of chloroquine, once the anti-malarial drug of choice, it took less than 20 years for resistance to spread from the borders of Thailand to Africa.
Study: Mosquitoes change habits to avoid anti-malaria nets
Nosten is worried that artemisinin resistance is growing much faster than he'd anticipated, with the drug failing initially to fully clear the parasite in more than half the cases he now sees.
"It initially goes after a few days, then it comes back. We see that more and more now," he said.
"In 2009, we still had 90 percent of patients cured. In 2010, it dropped to 60 to 70 percent. Now it's about 50 percent," he added.
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Ian Williams / NBC News
Migrants from Myanmar wait to be examined at a clinic on the Thai side of the border.
Some scientists claim this is too alarmist, since the parasite does eventually die, with longer treatment and higher drug doses, but Nosten sees no room for complacency.
"We have to respond quickly, not next year or three years' time. It's now or probably it will be too late," he said.
Artemisinin comes from a Chinese plant and is quick, potent and with no side effects. Little wonder it has been hailed as a wonder drug, the golden bullet in the global fight against malaria.
What makes the resistance so worrying is that there is no new drug ready to replace it.
Nosten said that although several drugs are in development, they could be five to 10 years away from deployment "if they make it … and we haven't got five to 10 years.”
The Shoklo Malaria Research Unit runs its own labs fashioned out of a sprawling old Thai house in the border town of Mae Sot, where teams of research scientists are working to better understand the parasite and the mosquitoes that carry it from person to person.
It is here that Chiara Andolina keeps mosquitoes that are literally hand-reared -- fed from her arm, which she extends through a mesh hole into a container of the hungry creatures every three days.
"Usually I feed around 600 of them in a cage like this," she said.
Of course these are not infected mosquitoes, though watching them settle on her arm for a good lunch is not a sight for the squeamish.
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In another room, Nosten settled over photographs showing the rapid development of the parasite once it has invaded a blood cell.
"If you can kill them very, very young -- like these -- they don't have time to develop into big fatty ones," he said, his pen jabbing at the photo. "These fatty ones are the ones that get stuck in your brain and kill you."
In other rooms, the DNA of parasites was being isolated and sequenced and drugs were being tested as part of Nosten and his team’s efforts to figure out what's behind the emerging resistance.
They are also looking for vulnerabilities and new ways to attack their enemy.
"It's hugely important to understand what's going on and contain it if we can," Nosten said. "We need to try things. We need to explore. It’s like exploring new territories in malaria."
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The French scientist has spent most of his working life in the tropics, initially with the medical humanitarian group Médecins Sans Frontières.
He believes he is engaged in a vital battle -- "a race against malaria" -- as he puts it.
After so many years on the malarial front lines, the battle has become deeply personal.
He dreams of completely eliminating this familiar but wily enemy.
However, he also knows that with the emergence of artemisinin resistance the stakes have never been higher.
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The world seems to want to ignore the health and welfare difficulties of Africa as much as possible.
A form of natural population control......
Amazing that man has walked on the moon, fused and split atoms yet the tiniest of bacteria and viruses could wipe out millions.....
Time to bring back the use of DDT for mosquitoes which was very effective, now that we know that Rachel Carlson (Silent Spring) and her worshippers LIED about the bad effects of DDT. It is a very safe pesticide and it controlled the mosquitoes like nothing else. Meanwhile, NOT using DDT is causing millions of people in the third world to DIE. Such a shame that the first world willingly gave up an effective way to prevent their deaths because of a politicial agenda
Time to bring back the use of DDT for mosquitoes which was very effective, now that we know that Rachel Carlson (Silent Spring) and her worshippers LIED about the bad effects of DDT. It is a very safe pesticide and it controlled the mosquitoes like nothing else. Meanwhile, NOT using DDT is causing millions of people in the third world to DIE. Such a shame that the first world willingly gave up an effective way to prevent their deaths because of a politicial agenda
Do you know anything about DDT or do you enjoy making a fool of yourself. DDT has a number of potential health impacts on humans and this may come as a surprise to you, but just like weeds become resistant to pesticides mosquitoes became resistant to DDT. Why? Because when you only use one chemical in large quantites species adapt to no longer be affected by it. Look it up.
Because of the use of DDT, malaria became almost no existent. It was no longer considered a threat. But as Liberty stated, we no longer use the product. no we replaced it with in effect screens to sleep under. Another situation where millions dies because of one person ignorance. But then, malaria is not a prevalent problem in the US or other countries where the so called rulers are so why should we all care about those people loosing their lives? As one poster pointed out- we need to reduce the surplus population anyways. HMMM Sound like something Ive read before or saw on TV.
What I find amusing is that it takes less than 50 comments before someone starts blaming the Republican party for the woes of the World.....never fails........
Or someone else blames the Democrats...
Ridiculous either way.
All this death can be averted. The WHO has finally said they were wrong about the effects of DDT on waterfowl and the eggs of nesting birds. DDT was and is the most effective chemical in the world for the control of malaria and control of mosquitoes. YOU CAN END THE CARNAGE! PUT DDT BACK INTO OPERATIONAL CONTROL. Just how stupid are the WHO leadership?
Bring back DDT and close the US boarders so other countries cant bring their crap here!!!
the environmental nazis of course PREVENT a CURE for malaria.
since the Lefists fools outlawed ddt, a proven eradication of malaria-born mosquitos, one million people EACH YEAR suffer and die, mostly women and children.
but the Left don't care. they worship the earth and pristine dirt, before they care about human life. after all, it is not their family, not in their city, it is only blacks in third world countries. and to the brain-damaged Left, it is only blacks and we are after all far too over-populated.
WTF are "environmental nazi's"?
Time to go back to "olive leaf" which they used before quinine became available,but you can get olive leaf extract today which is easier then making a tea of the leaves and drinking it.
So malaria is now going to possibly be a problem. It is not the first old disease to reappear. It certainly is not the last one to return. Man with all his machines and knowledge will continue to try save those who are dying but Jesus has another plan. God's plan. Look to the true God. The only God. Your time and my time is running out. Cry out to the Lord while he still hears us.
That is nothing but crazy ranting.. There is no jesus or lord. It's all in your mind. People are so brainwashed with these Fairy tales. Religion is the curse of mankind.
Trazan- Nothing cazy about what Beecee said- Time is short no matter how you look at it. Either Jesus will come again or you will at some point pass from this life on to another. The only question is where will YOU spend eternity? Your salavation is at hand. You may very well not survive the day. Your choice to believe or not. religion may be the curse but Christ is the saviour from the curse. And please don not confuse religion with Christianity. they are not 1 in the same
Wacko Jesus freaks, move to Iran with the rest of your kind please.
It's 2012, put down the bible and get an education. Fairy tales won't save our world from real problems.
If you had some semblance of an education you would know that the majority of Iraqis are muslim and do not believe as Christians do in the Lord Jesus Christ. They believe in the prophet Mohamed and Allah. A false god and prophet. So there are no Jesus freaks as such in Iraq as you suggest. You can call us what ever you like- does not matter. You will eventually find out the truth. Only God can save the world from its problems and the solution is coming. Have a nice day!
I learned all I need to know about false gods from the Goa'uld.
Religion was created by man to control the uneducated masses. Rulers found out a long time ago what you can accomplish with the fear of eternal damnation.
Ummmm....Kelldon, Christianity is a religion... and the leaders of this religion have changed their scriptures on numerous occasions to suit their own purposes, most of which involved oppression and murder of those who believe differently.
Too many people in the world now. This is natures way of controlling the population.
I always said that Scientist is a Big Joke along with their DNA...Oh and The malaria parasite -- carried by infected mosquitoes from person to person -- still kills an estimated 655,000 people a year. Wow and congress is worried about gun control....I guess their time and energy are spent in the wrong place..
Mosquitoes don't resist DDT!
Sometimes it seems the only thing human's seem to do consistently is procreate.
Then the hordes wait for someone to save them.
One out of every two people who have ever lived died of Malaria. (National Geographic)
All they need to do is start using DDT again. All the junk science about DDT being bad was just another crock.
Thousands of troops in Somalia had no problems when on Meflo-quine in 1993 but over the years enough people said it made them crazy so it was used much less. I guess the malaria parasite is resistant to this too?
just tack it on to obamacare, whats another trillion?
When the Panama Canal was built they sprayed all the standing water in the area with a layer of oil. This decimated the mosquito population, and the malaria along with it. Cheap, simple, and effective.
Cough.
Natural selection.
Cough.
Overpopulation.
Ahem.
Call me crazy, but I never get bit by mosquitos because I drink tonic water in the summer. It has quinine in it. They don't even land on me.
Hey, that's an idea - now just add some good gin and some freshly cut limes...
The limes are essential. My favorite form of vitamin C? The marguerita (with salt, thank you.)
There are several comments about bringing back DDT to combat malaria. DDT is highly poisonous to cats. Read the following story about cats being used to stop a Machupo virus plague in a mountainous area of Bolivia during the last century: The story on that web page is based on Laurie Garrett's book "The Coming Plague."
From my own life's experiences, this story has solved a mystery. When I'd been a girl, maybe 10 years old, I must have already had 5-15 cats in rapid succession. My parents kept visiting this place called "The Cat House" in Brighton, MA, where two old ladies sheltered many cats and kittens. My kittens all died, one after another. We started to think that we'd been continually given sick cats by the old ladies. Now I know that this was not the case. Every Sunday, after church, my father would spray DDT in the yard, to counteract the Japanese beetle invasion. Exposure to DDT was what killed my cats and might possibly also have been responsible three decades later for a history of breast cancer in our family.
You know, suppose cats get killed off by DDT. How many cats = 1 human child? I suppose there might be a link between DDT and some cancers but again, we know DDT if unchecked will wreak immediate havoc in the tropics. What's these tradeoffs?
Tom.... because people in Europe thought cats were demonic familiar spirits for witches...there was an all-out crusade against them. Because their numbers were so low, bubonic plague got a foot hold and wiped out over half of the population. Go ahead and kill off the cats....then, what will you do when the flea-borne plagues revisit? There are more rats in New York City than people as it is... Are you ready for that one?
Er, Lisa.....DDT kills fleas too.......but just to humor you, if there are so many rats in NYC now, where is the plague.....?
See the movie Idiocracy for reference....
DDT is effective in killing mosquitos when sprayed on interior walls of homes in malaria infested areas. Mosquitos that land on sprayed walls are killed by contact with the residue of DDT. However, its widespread use in agriculture to control other pests caused environmental damage and also allowed the mosquitos to develop resistance to it by constant low-level exposure.
This illustrates the natural human tendency to over-do a good thing until it causes more harm than good.
Right...just like liberalism! Lol
DDT is poisonous to cats. Cats are needed to keep the rodent population under control, since rodents are often the animal reservoirs of serious infections. In my previous comment they would not let me enter any URLs for reference. So search these terms online to read the following stories:
"The Machupo Virus" by John Kinsler (cascading selection story – Queen's Front Page / Queen's University) This is about cats stopping a hemorrhagic plague in Bolivia.
"Operation Cat Drop" by Patrick T. O'Shaughnessy; This is about cats being parachuted into Borneo to stop a plague.
ABC News – HealthDayNews – "DDT Compound Speeds Breast Cancer Growth" by Kevin McKeever, March 24, 2008
There is a very simple and safe solution. iv vit c. NO side effects either. But there is no money to be made from that so no one will even try. There are thousands of studies on it look it up.
There are several comments about bringing back DDT to combat malaria. DDT is highly poisonous to cats. Read the following story about cats being used to stop a Machupo virus plague in a mountainous area of Bolivia during the last century: The story on that web page is based on Laurie Garrett's book "The Coming Plague."
From my own life's experiences, this story has solved a mystery. When I'd been a girl, maybe 10 years old, I must have already had 5-15 cats in rapid succession. My parents kept visiting this place called "The Cat House" in Brighton, MA, where two old ladies sheltered many cats and kittens. My kittens all died, one after another. We started to think that we'd been continually given sick cats by the old ladies. Now I know that this was not the case. Every Sunday, after church, my father would spray DDT in the yard, to counteract the Japanese beetle invasion. Exposure to DDT was what killed my cats and might possibly also have been responsible three decades later for a history of breast cancer in our family.
Highly poisonous to all living things....nothing special about cats.
I've visited quite a few cat houses, but i have never left with a cat.
Good one!