Context:
- A recent global genetic study has revealed the emergence of artemisinin resistance in Africa, showing patterns similar to early resistance signals observed earlier in Southeast Asia.
- This development poses a serious threat to global malaria elimination efforts, especially as Africa accounts for the majority of malaria cases and deaths worldwide.
Key Highlights:
Scientific Background / Drug Details
- Artemisinin, derived from the Artemisia annua plant, was discovered in China under Project 523, led by Tu Youyou.
- Artemisinin-based Combination Therapies (ACTs) are the global first-line treatment against Plasmodium falciparum malaria.
Genetic Findings
- Resistance is linked to mutations in the kelch13 gene of the malaria parasite.
- The study analysed 1.1 lakh parasite samples from 73 countries over 43 years.
- 492 unique kelch13 mutations were identified.
- High prevalence regions in Africa:
- Rwanda
- Uganda
- Tanzania
- Eritrea
- Sudan
- Ethiopia
Nature of Resistance in Africa
- Unlike Southeast Asia, where resistance spread via imported mutant strains, African resistance appears to be independently emerging.
- Kelch13 mutations allow parasites to enter a slow-growth survival mode, reducing drug effectiveness.
Contributing Factors
- Incomplete treatment adherence
- Use of single-drug therapies
- Weak genetic surveillance systems
- Reduced malaria funding
- COVID-19 disruptions leading to fewer post-2019 samples and data gaps
Significance / Concerns
- Threatens the efficacy of ACTs, the backbone of malaria control.
- Risk of large-scale treatment failure in Africa.
- Could reverse decades of progress in malaria reduction.
Relevant Prelims Points:
- Issue: Emerging artemisinin resistance in Africa.
- Causes:
- Genetic mutations in kelch13 gene
- Drug pressure from widespread ACT use
- Poor monitoring and misuse of antimalarials
- Government / Global Initiatives:
- WHO Global Malaria Programme
- Roll Back Malaria Partnership
- Benefits of ACTs:
- High efficacy
- Reduced mortality
- Challenges:
- Drug resistance
- Weak health systems
- Surveillance gaps
- Impact:
- Increased malaria burden
- Global health security risk
Relevant Mains Points:
- Key Concepts & Definitions:
- Plasmodium falciparum: Deadliest malaria parasite species.
- Genetic Surveillance: Monitoring pathogen mutations to track resistance.
- Static + Current Linkages:
- Role of WHO in resistance monitoring.
- Lessons from Southeast Asia’s resistance spread.
- International Dimensions:
- Need for cross-border data sharing.
- Global funding cooperation.
- Way Forward:
- Strengthen genetic surveillance networks in Africa.
- Ensure strict treatment adherence.
- Monitor resistance to partner drugs in ACTs.
- Diversify antimalarial drug strategies.
- Restore funding and post-pandemic data collection mechanisms.
UPSC Relevance (GS-wise):
- GS Paper 3: Science & Technology (Biotechnology, Drug Resistance), Environment & Ecology (Disease burden).
- GS Paper 2: International Relations (Global health cooperation, WHO).
- Prelims: Drugs, diseases, genetic mutations, international health initiatives.