WHO and artemisinin resistance

Wednesday, 19/10/2016


What exactly is artemisinin?



World Health Organization which is abbreviated as WHO is concerned with worldwide public health and is a specialized agency of the United Nations. WHO and artemisinin resistance has been in the news for a while now but before digging deeper, it is important to have a concrete understanding about artemisinin itself. So, coming to the important questing here, what exactly is artemisinin?
Artemisinin and its derivatives are of medical use which isolated from sweet wormwood. Artemisinin is of primary importance for treating malaria for reducing the number of plasmodium parasites from the patient who is suffering from malaria. The connection of artemisinin resistance WHO recommends first line treatment of malaria by artemisinin based combination therapies which is also known as ACTs. It has reduced global malaria rate especially for its enormous success which were part of ACTs. Its enormous success was the reason why its treatment increased globally to 337 million from 11 million in just about eight to nine years. The role artemisinin play is to reduce the parasite load of the treatment during the first three days while the partner drug works in removing the remaining parasite. The artemisinin compound doesn’t clear out all parasites by three days in patients who are infected with artemisinin resistant strains of malaria. Though they are still cured as a part of a longer treatment, if only they are treated with an ACT containing a partner drug. WHO currently recommends 5 different types of ACTs. As of July 2016 it is confirmed that patients with artemisinin resistant parasites still recover after treatment if only they are treated with partner drug containing ACT. However, there is still a risk that multi-drug might emerge in other parts of sub regions as well. The artemisinin resistance is a consequence of several factors like lack of proper treatment, inadequate patient adherence and substandard drug quality. The geographical scope of this problem has widen quickly. In 2013, researchers identified a molecular marker, mutations in the Kelch 13 (K13) propeller domain were shown to be associated with delayed parasite clearance in vitro and in vivo. The marker could allow for a more detailed mapping and monitoring of the geographical distribution of resistance. It is also possible to enable retrospective mapping for resistance in large number of settings. WHO is working on the same, to map the presence of artemisinin resistance. The global plan to tackle this issue contains a set of technical recommendation on how to prevent and contain existing resistance from emerging anywhere else. WHO is also working with other countries which are affected so that they can ensure a rapid scale of malaria intervention. Global technical strategy for malaria, strategy for malaria elimination are some of the strategies made to address this issue.

The need of endemic countries to address the issue



However, making strategies aren’t the only thing, implementing the same are also needed and to implement it, financial resources are needed with political commitments that are long term. Cross border cooperation is also needed to improve the situation. The reason why this issues goes unaddressed because the endemic countries do not take active participation in these kinds of strategies. Hence, the government of endemic countries should take active participation and they need to take targeted measures to remove oral artemisinin based therapies and anti-malarial that do not meet international standard. African and Asian continent should take additional measures as they are the targeted countries in this matter. These continents should engage most of its resources to address the problem. One of the challenges is to strengthen roots of pharmaceutical regulations in countries which are facing these problems. Even WHO recommends the emergence of artemisinin resistance. Coming to the pharmaceuticals regulations, prescribed drugs should be made mandatory. Countries, especially like India where pharmaceutical regulations aren’t taken seriously at all should take notice of the same. Even today, medicines containing harmful drugs are given without any further questions and that too without prescription. The same should be stopped so that it can be one of first step to strengthen pharmaceutical regulations.

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