The anti-malarial drug Artemisinin has been found ineffective to cure the type malaria given by certain species of parasites. These artemisinin-resistant organisms are slowing down the international efforts to eradicate malaria. The first reports of resistant parasites have been observed in the borders of Cambodia and Thailand, and Thailand and Myanmar.

There seems to be a strong association between a region of chromosome 13 on the P falciparum genome and slower effectiveness rates, although this has yet to be confirmed. Several international efforts to contain the effects of these new drug-resistant parasites are being implemented. These include the Tracking Resistance to Artemisinin Collaboration>, funded by the UK Government Department for International Development (DFID) and the Global Plan for Arteminisinin resistance containment, created by the World Health Organisation (WHO). The first project is researching the issue in itself; the latter has outlined the necessary steps to research the causes of the phenomenon and, also, to contain and prevent the spreading of artemisinin resistance.

The development of artemisinin, one of the most common treatments for malaria, is rather complex and can take up to 18 months. One reason for that is that artemisinin is traditionally obtained from leaves of sweet wormwood (the so-called artemesia annua). However, now a breakthrough has been made in research where it appears that a synthetic version of artemisinin can be produced within 3 weeks. Here we consider the implications of these findings.

The synthetic version was engineered in labs that specialise in bioengineered yeast and the reports explaining how it works were recently published in Nature. Essentially, the researchers used a process to artificially build DNA strands in laboratories, which were then used to re-engineer microbes to behave as tiny factories. This is not a novel process, and currently the Bill Gates Foundation is supporting the development of these laboratories that are also looking into developing other treatments.

However, the creation of synthetic artemisinin comes at a cost of affecting farmers that grow sweet wormwood. Although artemisinin is the treatment that is most widely recommended by the WHO, there have been problems with the production of artemisinin in the past. These were mostly attributed to the unstable growth of wormwood trees. As such it has resulted in production delays and price fluctuations that have further complicated the matter. Based on this, we can sympathise with the researchers reasoning for creating a treatment that would be faster and more cost-efficient but equally effective.

But it is also important to remember that the use of wormwood trees should not be obliterated. While synthetic materials may be useful, they also often tend to be somewhat one-dimensional. Given that we already know about the risk of malaria parasites developing resistance to treatments, we need to allow for the option to develop flexible treatments when it is needed. Traditionally, these tend to stem from natural components that then become converted into synthetic versions.

A fuller version of the report can be read here.

The Online Clinic can prescribe malaria tablets for your trip but you need to check the latest advice for the particular region where you will be travelling. The NHS has a Fit for Travel website where you can look everything up by country and there is information within each country page for regions within that country. The website is very easy to use through the interactive map.

If you need any help working out what you need for your trip, please do not hesitate to call us – a member of staff would be more than happy to help. We have a 24 hour telephone service on 020 7127 9200.

The most popular malaria tablet is Malarone and that has just been approved in the UK as a generic product so the price has come down a bit. We can prescribe either brand Malarone or Generic Malarone – we give you the choice so long as it is appropriate. There are other malaria tablets, including Doxycycline, and we will give you the choice of everything that is appropriate for your region.

The Online Clinic does not prescribe Larium because of the risk of psychiatric side effects. We would only ever prescribe this medication by exception – i.e. when nothing else is appropriate. To get started, click on the free consultation button for your treatment.