# \[e-drug\] The adaptability of (malaria) parasites **URL:** \ **Category:** e-drug\ **Created:** [November 11, 2006, 12:24am UTC](https://talk.edrugplus.org/t/e-drug-the-adaptability-of-malaria-parasites/26742 "2006-11-11T00:24:59Z")\ **Posts on this page:** 1\ **Page:** 1
**Author:** ![Merrill\_Goozner](https://avatars.discourse-cdn.com/v4/letter/m/8c91f0/32.png) [@Merrill\_Goozner](https://talk.edrugplus.org/u/Merrill_Goozner)\ **Post date:** [November 11, 2006, 12:24am UTC](https://talk.edrugplus.org/t/e-drug-the-adaptability-of-malaria-parasites/26742/1 "2006-11-11T00:24:59Z")
E-DRUG: The adaptability of (malaria) parasites ------------------------------------- [This is the link to the article which is mentioned. Free in full text [http://content.nejm.org/cgi/content/full/355/19/1959](http://content.nejm.org/cgi/content/full/355/19/1959). Moderator] The Adaptability of Parasites The virulent strain of the malaria parasite has grown resistant to chloroquine, the most common drug used to combat the disease. So several million mostly African children die every year even though many of their desperate parents buy them medicine that they think is going to work. The economics of the situation are perverse. Chloroquine costs 10 cents a day, something poor people can afford. Drugs that work like artemisinin (the fast-acting, fast-clearing drug is used in combination with older drugs to avoid its falling victim to resistance) costs $2.50 a day. If you made $2 a day or less like most people in Africa, which would you choose? Today's New England Journal of Medicine contains a report from Malawi showing that if chloroquine is discontinued for a decade or so, the malaria parasite evolves to the point where it once again become susceptible to the drug's action. It turns out that the genetic mutation that confers resistance makes the parasite somewhat weaker overall. Without the selective pressure of the drug, the susceptible strain resumes its dominance in the overall population. So should chloroquine be reintroduced in those countries that are following the World Health Organization's advice and switching to artemisinin-based combination therapy for treating malaria? Absolutely not, says Nicholas White of Mahidol University in Bangkok, who is probably the world's leading malariologist. In an accompanying perspective article, White points out that "if chloroquine were reintroduced alone, resistant parasites would probably return rapidly, imported in people from neighboring areas." He holds out hope that chloroquine can once again become a useful drug, but not until it is stopped everywhere for a long period of time. "It needs to leave before it can come back." Meanwhile, the World Bank and other multi-lateral aid organizations are dragging their feet in implementing the 2004 Institute of Medicine report that called for setting up a global fund to purchase 500 million doses of ACT a year for use in the developing world (it would cost about $1.5 billion a year). This central authority could then distribute it through the same channels that currently distribute chloroquine -- and at the same price. That way, the desperate mothers of the two million children who die each year could not only afford to buy their children medicine, but they would be assured that the medicine they give them works. Merrill Goozner merrill@goozner.com [http://www.gooznews.com/](http://www.gooznews.com/)