These new treatments could save thousands of lives every day

Dr Shigeru Omi WHO

Resistance to anti-malarial drugs is causing a major concern especially in Africa and some of the poorer nations that are more susceptible to the disease.

The World Health Organisation claims the best hope for a cure to malaria is emerging from China, which is developing a range of highly effective medicines that include a derivative of a traditional herb artemisinin.

The new treatments combine artemisinin, an extremely powerful anti-malarial agent, with modern synthetic drugs.

At least four treatments are being developed - one is already available, while another therapy, which is likely to be less costly, may be on the market within two years.

Cure rate

These combinations have a cure rate of more than 95% against malaria. Advantages of the new treatments are that:

• they only need to be taken for three days, compared to week-long treatments for other drugs
• they use compounds that the malaria parasite has yet to develop resistance to
• they are likely to be cheap enough for the poor to afford.

The WTO is working to accelerate the development of the treatments by providing international support for clinical trials and safety and production quality assessment.

At a conference in Shanghai on Friday and Saturday, Chinese scientists and drug manufacturers, plus potential foreign partners, will discuss ways of reducing the resistance to anti-malarial drugs.

Malaria accounts for one in five deaths of children under five in Africa

Dr Shigeru Omi WHO

Dr Shigeru Omi, WHO's Western Pacific Regional Director, said: "These new treatments could save thousands of lives every day.

"This is why we're trying to speed up the process."

Professor David Warhurst, of the Public Health Laboratory malaria reference laboratory, said drug resistance to malaria was very problematic.

'Important drug'

"Artemisinin is a very important drug," he said. "It is a very rapidly reacting agent that actually reduces the number of parasites in the blood to very small numbers."

Novartis, which helped with the development of a therapy called Coartem, signed an agreement with WHO in May to provide developing countries with the drug at the cost price of US$2.40 per adult treatment.

Other treatments under development are set to be less costly and affordable to most, if not all malaria patients in the world.

China rediscovered artemisinin a quarter of a century ago. It has long been used to treat fever and probably malaria. It can kill 99% of malaria parasites within 48 hours, but to completely cure infections, it has to be taken for a week.

But Dr Allan Schapira, WHO's Western Pacific Regional Adviser on malaria, said some people were stopping the treatment after two days because they felt better.

They then become ill again in a few weeks and experts fear that this could also lead to the malaria parasite becoming resistant to artemisinin.

'Extensive resistance'

Professor Warhurst said the most economic and safest anti-malarial drug, chloroqine, was showing "extensive resistance".

Drug resistance is a severe problem in south-east Asia and South America, particularly in Thailand, Cambodia, China, Vietnam, Brazil and more recently in Africa.

Scientists in China have spent 10 years researching combinations of anti-malarial drugs to counteract the problem.

Taking two or more drugs together improves efficacy, reduces the duration of treatment and is likely to delay the parasites drug resistance.

Combination treatments have also been effective against tuberculosis and Aids.

Dr Schapira said: "There is a double rationale for this. First, we're giving people a better chance to get well. Secondly, we are also delaying the advent of resistance to the drugs.

"China can take credit for a great achievement. It is now in a position to stop people dying from malaria," added Dr Schapira.