Malaria resistance to drug treatment is on the rise in Southeast Asia. Drugs from China, India & Vietnam that don't follow WHO standards is the reason.
Photo above of a mosquito carrying the disease malaria feeding on a human arm (Source: Wikipedia)
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Fake malaria drugs a growing problem: experts by Kerry Sheridan (AFP)
WASHINGTON — Fake or poor quality malaria drugs are boosting resistance in parts of southeast Asia, a problem that is likely to worsen unless tighter regulations are adopted, US experts said Monday.
"The malaria parasite has a history of adapting to drugs and adapting to insecticides," Regina Rabinovich, director of infectious diseases at the Bill and Melinda Gates Foundation, told a hearing of US lawmakers.
Drug resistance to the most effective drug available, artemisinin-based combination therapy, is developing and has been recognized in southeast Asia.
Last month, the World Health Organization said resistance to artemisinin appeared to be spreading in the region from the Cambodia-Thailand border, where it was first detected in 2009, and possibly moving into Myanmar.
Half of the world's population is exposed to the mosquito-borne disease which kills 860,000 people every year, according to the WHO.
According to Roger Bate of the American Enterprise Institute, research has shown that about half the malaria drugs that failed quality control tests also contained some artemisinin.
"So they are directly contributing to resistance," he told lawmakers at the House subcommitee on Africa, Global Health, and Human Rights.
"Resistance is being noticed on the Thai, Cambodian, Burmese borders and resistance is likely to increase," he said.
Fake and substandard antimalarial medications are a significant and probably growing problem.
While the actual number of poor quality drugs in circulation is unknown, "it is certainly not a negligible amount," he added, and the problem is festering because these medications are not illegal in the countries affected.
"Simply getting the medical regulatory authorities to control what is on the market for anti malarials I think is important," said Bate
The sale and use of monotherapies, which contain just one active agent, have long been known to contribute to resistance. Experts favor combination therapies which last longer.
Bate said that coordinated action to get monotherapies off the market in Africa has shown some success, "but some companies in China, India and Vietnam are still producing them and this is a major contribution to resistance."
And that will definitely extend the life of any of those new drugs we develop going forward.
Rabinovich echoed that point, saying that the drugs of today will not be effective tomorrow.
"Research and development is essential because the preventive and curative tools that are available today and are so effective at controlling malaria are not sufficient to control malaria in the long term or for eradication due in part to the development of resistance," she said
In addition to tougher regulations, researchers need to focus on developing new drugs against malaria, and consider making sure they cannot be sold or distributed as monotherapies, the panelists urged.
"The goal now going forward is the new drugs we develop need to be made as fixed dose combinations immediately, and never be sold or available as single entities," said Dennis Schmatz, president of Medicines for Malaria Venture North America, Inc.
Copyright © 2011 AFP. All rights reserved.
(Source: Bangkok Post, Fake malaria drugs a growing problem: experts, Kerry Sheridan (AFP), link)
Malaria Drug Resistance Vocabulary
malaria - "a mosquito-borne infectious disease of humans , the disease results from the multiplication of parasites within red blood cells, causing fever and headache, in severe cases progressing to coma or death. It is widespread in tropical and subtropical regions, including much of Sub-Saharan Africa, Asia, and the Americas" (See Wikipedia) ไข้มาลาเรีย
infectious diseases - diseases caused by viruses, bacteria, fungi, protozoa, multicellular parasites, and aberrant proteins known as prions, that pass from person to person or from animal to person by physical contact, contaminated food, body fluids, objects, and breathing through the air (See Wikipedia)
Bill and Melinda Gates Foundation - an organization that provides money for health-related projects around the world: "the largest transparently operated private foundation in the world, founded by Bill and Melinda Gates... The primary aims of the foundation are, globally, to enhance healthcare and reduce extreme poverty, and in America, to expand educational opportunities and access to information technology. ... It had an endowment of US$33.5 billion as of December 31, 2009. The scale of the foundation and the way it seeks to apply business techniques to giving makes it one of the leaders in the philanthrocapitalism revolution in global philanthropy" (See Wikipedia)
population - the group of people who live in one country, area or place กลุ่มพืชและสัตว์ที่อาศัยอยู่ในบริเวณหนึ่ง
exposed - openly affected by and not protected from ได้รับ ในที่นี้หมายถึง สูดควันบุหรี่; ได้รับ ได้สัมผัส (แดด หรือสารพิษ เป็นต้น)
borne - carried ถือ หรือนำไป (อัญเชิญ ประดิษฐาน)
mosquito-borne disease - a disease carried by mosquitos; that people catch from mosquitos
half of the world's population is exposed to the mosquito-borne disease [malaria] which kills 860,000 people every year
malaria drugs - drugs designed to prevent or cure malaria (See Wikipedia)
anti malarials - same as "malaria drugs"
fake - not real (made to look like the real thing but they are not) ของปลอม
fake malaria drugs - drugs that look real, but are not real
fake malaria drugs a growing problem
parasite - a small animal that lives inside a larger animal and gets its food from the larger animal ปรสิต, พยาธิ (See Wikipedia)
artemisinin - "a group of drugs that possess the most rapid action of all current drugs against falciparum malaria. Treatments containing an artemisinin derivative (artemisinin-combination therapies, ACTs) are now standard treatment worldwide for falciparum malaria. The starting compound artemisinin is isolated from the plant Artemisia annua, a herb described in Chinese traditional medicine" (See Wikipedia)
falciparum malaria - the most dangerous form of malaria with the highest rates of complications and mortality, almost all global malarial deaths are caused by this variety, more exact name: Plasmodium Falciparum (See Wikipedia)
artemisinin-based - using the drug artemisinin
artemisinin-based combination therapy (ACT) - the right way to treat malaria, "the World Health Organisation has recommended that artemisinin combination therapies (ACT) be first-line therapy for P. falciparum malaria worldwide. Combinations are effective because the artemisinin component kills the majority of parasites at the start of the treatment while the more slowly eliminated partner drug clears the remaining parasites. Several fixed-dose ACTs are now available containing an artemisinin component and a partner drug which has a long half-life, such as mefloquine (ASMQ), lumefantrine (Coartem), amodiaquine (ASAQ), piperaquine (Duo-Cotecxin) and pyronaridine (Pyramax)" (See Wikipedia)
therapy - a medical treatment to cure a disease; a treatment which helps someone feel better, grow stronger, etc., especially after an illness การบำบัดโรค (See Wikipedia)
mono - one; single
monotherapies - therapy to sure a disease that uses only one drug
combination - the mixture you get when two or more things are combined การรวมกัน
combination therapies - a therapy to cure a disease that uses more than one drug
dose - an amount of drug that you take at a single time ปริมาณยาที่ให้ต่อครั้ง
fixed dose - a certain amount of a drug taken at one time
fixed dose combinations
drug resistance - when a drug loses its ability to cure a disease over time (See Wikipedia)
resistance - same as "drug resistance"
development of resistance - when a drug gradually loses its ability to cure diseases
contribution - one one of the things that causes something; something that you do that helps to produce something or achieve something ผลงาน,การช่วยเหลือ
a major contribution to resistance - something that causes drug resistance
contribute - to make a regular payment
contribute to resistance
contributing to resistance
boosting - increasing เพิ่ม
boosting resistance - increasing drug resistance
insecticides - a chemical used to kill insects (See Wikipedia)
adapting to drugs - developing and gaining resistance to drugs (so they cannot cure disease anymore)
adapting to insecticides
effective - works well, gets the job done; producing the result that was intended ได้ผลดี
effective drug - a drug that cures a disease
regulations - rules made by the government to control how some activity is done กฎระเบียบ ระเบียบปฏิบัติ ระเบียบ ข้อบังคับ
adopt regulations - start using regulations
a problem that is likely to worsen unless tighter regulations are adopted
US lawmakers - the US congress (the elected representatives that make laws) (See Wikipedia)
border - the official line separating two areas, regions or countries เขตแดน อาณาเขต
the Cambodia-Thailand border
detected - noticed, discovered or found out จับได้ พบได้
first detected in 2009, and possibly moving into Myanmar
contains - has inside of it บรรจุ มี
X contains Y - X has Y inside of it
quality - คุณภาพ
quality control - การควบคุมคุณภาพ (See Wikipedia)
quality control tests - checking for the quality of products when they are produced
failed quality control tests - check for quality above a standard (and quality was below a standard)
failed quality control tests also contained some artemisinin
substandard - quality below quality requirements set by government; not good to be accepted; fails tests ต่ำกว่ามาตราฐาน
medications - medicine
significant - important สำคัญ
significant problem - an important problem
fake and substandard antimalarial medications are a significant and probably growing problem
the problem is festering - the problem is getting worse
in circulation - that people have and are using
actual - real; existing in fact จริง
while the actual number of poor quality drugs in circulation is unknown
negligible - very small or unimportant ซึ่งไม่สลักสำคัญ
certainly not a negligible amount
illegal - against the law ผิดกฎหมาย, นอกกฎหมาย
these medications are not illegal in the countries affected
authorities - government officials; the police or people in official organisations who have the legal power to make people obey laws or rules เจ้าหน้าที่ (ตำรวจ หรือผู้มีอำนาจ)
medical regulatory authorities - the government officials who enforce laws against drugs being sold
active - working, operating, doing some function, work or job
active agent - the part of a drug that actually cures disease (See Wikipedia)
coordinated - working together to achieve a goal ทำงานร่วมกัน
coordinated action to get monotherapies off the market in Africa
extend - to add more time ยืดออกไป
extend the life - make the life longer, add to the life
that will definitely extend the life of any of those new drugs we develop going forward.
echoed that point - said he agreed with something that another person said (a "point" in their argument)
effective - successfully completes the task it is chosen to do; achieves it goals
the drugs of today will not be effective tomorrow
research and development (R&D) - research work using engineering or science to create new products, improve existing products or improve the process of producing and manufacturing a product (See Wikipedia)
essential - necessary and important ที่จำเป็น ที่สำคัญ
research and development is essential
sufficient - enough พอเพียง
sufficient to control malaria
eradicate (verb) - get rid of, eliminate
eradication - the process of getting rid of and eliminating something การถอนรากถอนโคน, การกำจัด, การทำลาย
focus - think about and work on one thing (rather than waste time on many), concentrate time and attention on one thing ให้ความสำคัญ
researchers need to focus on developing new drugs against malaria
distributed - made available to customers through stores and middlemen
distributed as monotherapies
panel - a group of experts gathered together to meet and discuss a problem and provide advice and suggestions on who to solve the problem
panelists - the experts on the panel
urged - requested them to do, enouraged people to do, tried to get them to do; advised someone very strongly about what action should be taken วิงวอน
the panelists urged
immediately - happening right after something else with no delay; right away ทันที
single - one
single entity - only one thing
sold or available as single entities - sold or available as one thing (not in a combination of many things)
rights - what the law allows you to have and do; something you are legally or morally allowed to do or have สิทธิ์ (See Wikipedia)
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