by Aida Olkkonen
April 7, 2011
The theme of this year's World Health Day, held annually on April 7th, is “Antimicrobial resistance: no action today, no cure tomorrow.” According to the World Health Organization, about 440,000 new cases of multidrug-resistant tuberculosis (MDR-TB) emerge annually, causing at least 150,000 deaths. In addition to earlier generation anti-malarial medicines, malaria parasites resistant to standard treatments are now emerging in Southeast Asia. Drug resistance is also a concern with hospital-acquired infections, HIV infection, and other infections. Not only does drug-resistance reduce chances of successful treatment, but it also increases the probability of spreading the resistant micro-organism to others and increases the costs of health care.
MDR TB is a growing problem in many of the countries where URC works, particularly in countries with a high HIV burden. URC is helping National Tuberculosis Programs in a number of countries to strengthen their response to MDR TB by assisting partners with implementing programmatic management of MDR TB, improving awareness and implementation of infection control strategies, and ensuring access to second-line drugs. In South Africa and Swaziland for example, URC staff members are currently involved in developing models for managing MDR TB at the community level, which a growing body of evidence shows is the most effective means of detecting and treating MDR TB cases. In Lesotho and Botswana, URC has worked with the National Treatment Program to develop and implement guidelines for the programmatic management of MDR TB.
The Western provinces of Cambodia are at the epicenter of drug-resistant malaria. While direct evidence of resistance to standard treatments such as artemisinin combination therapy has not yet been reported, there has been a noted increase in therapeutic failures among patients with uncomplicated cases treated with these drugs in the Mekong region. The average time for infections to clear up has also increased. Early detection of such resistance is critical for timely response against the spread of resistant parasites. URC’s Malaria Control in Cambodia project funded by USAID is currently conducting operations research to define the geographical distribution of potential drug-resistant carriers in order to better target the containment interventions for the spread of MDR parasites. It is expected that this research will provide a better understanding of the dynamics of the spread of multi-drug resistant (MDR) malaria at local levels and reduce the prevalence and the transmission of those MDR strains.