Vietnam continues fight against its greatest war-era enemy

By Calvin Godfrey February 15, 2017 | 02:09 am PT

An Anopheles stephensi mosquito obtains a blood meal from a human host in an undated handout photo Photo by Reuters /Jim Gathany/CDC

Researchers call for a regional solution to the threat of drug-resistant malaria in the region

Early this month, a team of researchers announced that the dominant strain of deadly malaria in Southeast Asia has developed resistance to the world’s first line of defense against the disease.

Sir Nicholas White, one of the lead researchers on the study published early this month in the Lancet, called on governments to take extraordinary measures to stop the strain before it spreads into Africa, which sees the vast majority of malaria infections and 90 percent of fatalities related to the disease.

“I think Vietnam has done very well in the last 25 years,” White told VnExpress International via telephone. “But it’s still got malaria.”

Tribes of drug-resistant malarial parasites have been brewing in western Cambodia for the past decade without inspiring the kind of response that government and intra-governmental agencies mustered for bird flu, White said.

Now a strain of malaria bugs that dominates parts of Thailand, Laos, Cambodia and “probably” Vietnam has developed a resistance to the drug originally created to save Communist guerilla soldiers.

The fevers, vomiting and profuse sweating caused by malaria begin roughly two weeks after a mosquito unknowingly introduces protozoan parasites carried in its saliva to the blood of an unlucky human or animal.

Fifty years ago, the illness wreaked havoc on the developing world and came to infect nearly every Vietnamese soldier fighting his way through the jungle penumbras of Cambodia and Laos.

President Ho Chi Minh called on Chinese leaders to develop new treatment for malaria, a task assigned to Tu Youyou, who found the world’s most effective cure in a 1,600-year-old recipe that called for steeping a traditional herb (Artismenin annua) in cold water. The compound yielded by the tea, Artismenin, saved millions of lives by rapidly attacking the mosquito-borne parasites before they could develop in their host.

The drug remains the foundation for all malaria treatment cocktails, otherwise known as Artemisinin-based Combination Therapies (ACT).

Three years ago, researchers in western Cambodia warned of widespread resistance to an established ACT course and called for doubling the treatment due to mutations in plasmodium falciparum – a species of the parasite associated with fatal cases.

Back in 2014, a national health official assured a Cambodia Daily reporter that the drugs used to fight P. falciparum still worked in the eastern part of the country, which borders Vietnam.

“The ministers of health of the region are apparently concerned with these things,” Dr. White said. “But our view is that the threat posed by this for the world, the priorities put on it are not appropriate.”

White pointed out that Zika has been treated as a virus of international concern despite posing far less of a threat to the human race.

“Malaria is an awful disease that kills 2,000 people a day,” he said. “The first thing is to raise it up as a priority, not just for the countries themselves but for the region.”

In Vietnam, the response remains largely local.

Vietnam’s national program has brought rapid testing, drug treatment and the distribution of bed nets laced with a long-term insecticide to the few forested provinces in Vietnam that still see cases, according to Dr. Tran Cong Dai, the World Health Organizatin’s malaria expert in Hanoi.

“Vietnam is on track to eliminate malaria by 2025, particularly P. falciparum” Dai worte in an email. “That is most optimum approach to contain malaria drug resistance.”

A little over 4,000 people contracted malaria in Vietnam last year — a 55 percent drop in cases from the previous year.

Nevertheless, the drug-resistant malaria has spread, geographically, from one province to six.

“Currently, we cannot say how many cases of P. falciparum are ACT resistant in Vietnam because the number of cases of malaria is small,” Dai wrote. “It is important to note that drugs used to treat malaria in Vietnam are still effective to the vast majority of malaria cases.”