As if malaria weren t misery enough

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As the global health community works to increase access to malaria treatment and prevention measures, two significant obstacles are becoming increasingly serious. Counterfeit and poorly manufactureddrugs, along with higher levels of insecticide resistance among malaria-carrying mosquitoes, are hindering the public health community s efforts to tackle malaria, which kills somewhere between 650,000 and 1.2 million people annually especially young children and infants in sub-Saharan Africa.

A new study by researchers at the Fogarty International Center at the National Institutes of Health, published in The Lancet Infectious Diseases, demonstrated the ineffectiveness of many malaria drugs currently being sold. Upon examining 1,500 samples of malaria drugs from seven Southeast Asian countries, the researchers found that a substantial number over one-third were fake or of substandard quality. Similar results have been found in 21 sub-Saharan African countries, suggesting that this is a widespread phenomenon. The study authors report that a lack of quality-control oversight, insufficient punishment for drug counterfeiters, and poor knowledge about treatment among the population and health workers are all contributing to the ongoing problems of ineffective and fake medicines. Beyond endangering one s health, these low-quality drugs can increase the risk of developing drug-resistant strains of malaria.

Furthermore, researchers are finding that mosquito resistance to insecticides is becoming increasingly problematic in regions of the world where malaria is endemic. The World Health Organization (WHO) reports that such resistance has been identified in 64 countries. There are four main classes of insecticides employed in the WHO s anti-malarial efforts; in every region where malaria is endemic, researchers have found resistance to at least one of these classes of insecticides. In certain places, in fact, there is resistance to all four types.

The tools we have today work extremely well in almost all settings, so we don t want people throwing their hands up in the air and saying this is a catastrophe, explains Dr. Robert Newman, director of the WHO s global malaria program. But, he notes, it s important that we buy ourselves many more years of being able to use them by responding quickly when we find resistance and proactively putting in strategies to stop the emergence of resistance ¦ These steps will both counter the toll of malaria and decrease the price of malaria control programs which currently cost $1.5 billion each year.

And ACSH s Dr. Gilbert Ross wants to be sure to remind readers that, far from being the frightening and dangerous chemical it s often made out to be, DDT is actually a vital part of malaria prevention efforts. DDT is an important component of insecticide programs used to control the spread of malaria, and its use has helped to reduce the toll of this disease, he notes. Unlike what you may hear in the media, DDT is very safe for indoor spraying.

ACSH advisor Jay Lehr agrees with Dr. Ross. Reflecting on anti-DDT campaigns that hindered its use in the earlier days of the fight against malaria, he observes that it is amazing how many people died at the hand of environmental zealots who wrongly condemn DDT.