New single-dose medicines are being developed to tackle the problems of parasite resistance and people not taking the full 3-day regimen of prescribed medicines.
Just as mosquitoes are showing signs of resistance to common insecticides used in some nets and sprays, the malaria parasites they transfer between people are showing signs of resistance to today’s medicines.
Part of the reason is that drugs to treat malaria typically need to be taken over 3 or more days, but their effects can be felt sooner. “It is not surprising, then, that not all people keep to their drug treatment regime,” says David Reddy, CEO of Malaria Medicines Venture (MMV), a research foundation dedicated to developing new anti-malarial drugs.
The drugs that treat malaria are fast; you find people start to feel better and stop taking their medicine.David Reddy, CEO of Malaria Medicines Venture
“It’s very similar to the situation with antibiotic resistance. The drugs people are given to treat their malaria are very effective and they work fast. So, you often find that people start to feel better and stop taking their medicine. This has a twin effect. First, they don’t get completely cured, meaning the parasites live on and start to develop resistance. Second, when a mosquito transfers these mutated parasites to another person, they’re resistant to the drugs that person is given.”
Progress towards new medicines is very encouraging, Reddy reveals. For treating people suffering from relapsing malaria, a drug is in development that will reduce a 14-day regime down to a single pill. “This will help care-givers ensure that patients take their entire dose; and there won’t be a problem with non-compliance,” he says.
If all goes well, the new medicine, which is already undergoing human trials, could be available within this decade.
The same is true of a promising drug for cases of uncomplicated malaria which would reduce treatment regimens from 3 days to a single dose.
“Single-dose treatments also mean that we could take a different approach to malaria control and proactively administer medicines to an entire area where everyone would take their pills on the same day and thus kill off the parasites in that region. If you kill off the parasites, there are none for mosquitoes to transfer from person to person when they bite.”
It would take a considerable amount of cooperation between health authorities on the ground but, if well-coordinated, wide areas could be freed of parasites in one fell swoop. It would be an exercise that needs to be repeated but could be a very effective, new, proactive intervention in the fight against malaria, increasing the operational feasibility of malaria elimination programmes.