12 January - The United Nations health agency today launched a new action plan to halt the spread of resistance to artemisinin, the world's most potent treatment for malaria, warning that the tremendous gains made in recent years against the disease are under threat.

Launched by the UN World Health Organization (WHO) and the Roll Back Malaria Partnership (RBM), the plan outlines actions to contain and prevent resistance to artemisinins, which are the critical component of artemisinin-based combination therapies (ACTs), the most potent weapon in treating falciparum malaria, the deadliest form of the disease.

“The usefulness of our most potent weapon in treating malaria is now under threat,” said WHO Director-General Margaret Chan.

“The new plan takes advantage of an unprecedented opportunity in the history of malaria control: to stop the emergence of drug resistance at its source and prevent further international spread. The consequences of widespread artemisinin resistance compel us to seize this opportunity.”

Resistance to artemisinins has already emerged in areas on the Cambodia-Thailand border, according to WHO, which warns that if these treatments fail, many countries will have nothing to fall back on.

“We believe that the plan has every good chance of success. Above all, the international community is duty bound to seize this opportunity. Too much is at stake if we fail,” Dr. Chan said at the launch of the plan in Geneva. “It is no exaggeration for me to say that the consequences of wide-spread resistance to artemisinins would be catastrophic.”

The five-step Global Plan for Artemisinin Resistance Containment aims to contain and prevent artemisinin resistance by stopping the spread of resistant parasites, increase monitoring and surveillance for artemisinin resistance, improve access to malaria diagnostic testing and rational treatment with ACTs, invest in artemisinin resistance-related research, and motivate action and mobilize resources.

WHO emphasizes that the success of the plan will depend on a well coordinated and adequately funded response from many actors at global, regional and national levels.

“''Effective containment of artemisinin resistance will significantly improve our capability to sustain current control achievements at country level,”'' said Awa Coll-Seck, Executive Director of the Roll Back Malaria Partnership. “We now have a coordinated plan to stop the spread of resistant parasites, but we need additional funding to fully implement it.”

WHO estimates that the number of malaria cases has fallen by more than 50 per cent in 43 countries over the past decade. A recent analysis of malaria prevention in 34 African countries estimates that more than 730,000 lives were saved between 2000 and 2010 nearly three quarters of them since 2006, when the use of both insecticide-treated mosquito nets and ACTs became more widespread. The loss of ACTs as an effective treatment would likely result in a significant increase in malaria-related deaths, the agency warned.

“The emergence of artemisinin resistance has been a wake-up call. It gives us another compelling reason to step up existing control measures with the greatest sense of urgency,” said Dr. Chan. “The global plan spells out clearly what needs to be done. It is my sincere wish that the international community will seize this unprecedented opportunity.”