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Malaria is resurging with a vengeance

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    Posted: June 30 2018 at 1:32pm

Malaria is resurging with a vengeance on our doorstep but the new drug tafenoquine offers hope

By Benjamin Rolfe

Posted about an hour ago

Disease outbreaks such as Ebola are genuinely terrifying.

We normally associate them with the exotic and the unknown — UN emergency workers tramping through African dust in biohazard suits, fighting a rearguard action against a mysterious foe.

However, just 150 kilometres north of Australia a more familiar epidemic is unfolding. An ancient parasite is spreading faster than at any time this century.

In Papua New Guinea, malaria is resurging with a vengeance. There were an estimated 1.4 million malaria cases in the country in 2016, which amounts to a 400 per cent increase, according to the World Health Organisation; 3000 people died.

Close to 60 per cent of malaria cases in PNG are among children under 15 years and too many don't survive the onslaught.

A little further north, malaria is morphing into new and dangerous strains. In the Greater Mekong Subregion, malaria parasites are developing resistance to the main medicine, artemisinin combination therapy.

In parts of Cambodia, 60 per cent of malaria treatments are impaired; in parts of Vietnam, the rate is 30 per cent and rapidly increasing.

There are very few "combination drugs" left to treat malaria in the region and time is running out.

Soon, malaria may become untreatable.

If drug-resistant malaria spreads across Myanmar into India and Africa the global death toll would be immense.

A life-saving drug in the pipeline

Thankfully, medicine and science provide new hope.

A breakthrough medicine, tafenoquine, is currently being reviewed by Australia's therapeutic goods administration.

This medicine provides a radical cure for recurring malaria, moving from the current 12 dose course to a single tablet.

Relapsing malaria accounts for half the Asia Pacific's malaria burden, so draining this reservoir of infection is an important step towards malaria elimination. Its likely approval would be particularly useful in the Pacific.

The Commonwealth recently announced a significant investment in medicine approval systems across the Asia Pacific. By sharing its technical expertise, Australia can help make Tafenoquine available where it is needed. This will lead to faster uptake of drugs like tafenoquine.

Rapid diagnostic testing is the other side of the innovation equation, allowing a potential case to be diagnosed in under 15 minutes. Australia is helping to make these available, but we can and should accelerate progress.

Aussies aren't immune

In wealthy, developed Australia, it is comforting to think we are immune to such outbreaks. However, in a globally connected world, this might be a foolhardy assumption. Just last September, for example, a four-year-old girl died of cerebral malaria in northern Italy.

Every year we don't eliminate malaria is another year of unfulfilled human and economic potential.

Malaria's effect on education, training and productivity in our own region is an economic deadweight on our collective prosperity. Eliminating malaria from the Asia Pacific by 2030 will provide savings in health care costs, lost wages and productivity of about US$90 billion. A study of Latin America and the United States found the average yearly income of those born after malaria eradication campaigns increased about 25 per cent, on a like for like basis.

It is in all our interests to maintain progress towards malaria elimination.

Australia's leadership is saving lives

Australia's commitment to fight the world's deadliest animal, the mosquito, is also political. In 2014, Australia led 18 governments to commit to eliminate malaria by 2030. Since then, domestic financing among those nations has increased 40 per cent. This is an overlooked benefit of smart aid.

When wealthy nations show leadership, it galvanises others.

More recently, Foreign Affairs Minister Julie Bishop bolstered Australia's commitment to end malaria by joining the End Malaria Council in London. Again, this was galvanizing and led PNG, Solomon Islands and Vanuatu to accelerate their efforts to end malaria by 2030. As global funding sources will gradually phase out of the region, Australia's leadership is especially important.

In the first week of July, Melbourne will host the Malaria World Congress. As we tackle this millennia-old disease we must harden our scientific, financial and political will to end malaria for good.

Dr Benjamin Rolfe is chief executive of the Asia Pacific Leaders Malaria Alliance.

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