An Old Tool in Fight Against Malaria Reemerges

Malaria kills more than a million people annually, and drug-resistant strains have made the fight ever more difficult. So, when one of the old drugs suddenly appears to have regained its potency against the scourge, you have to sit up and take note.

A crucial malaria drug that lost its punch in most countries because of germ resistance now appears to be highly effective again in one African nation — a startling shift with implications for other tough bugs. It appears to be the first time a drug widely used against a killer disease has regained effectiveness after a break in use.

"We didn't expect to see this," said researcher Dr. Christopher Plowe of the University of Maryland School of Medicine. "I'm not aware of any case where a drug wasn't working clinically and was withdrawn and now is 100 percent effective again."

The drug, chloroquine, was for many years the standard for treating malaria because it is very cheap, effective and safe. But in 1993, doctors stopped using it in the African nation of Malawi, because it was no longer effective in fighting most malaria cases.

However, in recent years, researchers saw signs of genetic shifts in malaria that suggested it might again be vulnerable to chloroquine.

University of Maryland researchers tested it in 105 malaria-infected children at a clinic in central Malawi. An astounding 99 percent of them were cured, far better than the results of two drugs tested on another group of children.

The findings, reported in Thursday's issue of the New England Journal of Medicine, show that other African nations should stop using chloroquine, as the World Health Organization recommends. Once evidence shows the drug works again, experts say, those countries could resume using it, but in combination with other antimalarial drugs. Research shows infectious agents are far less likely to develop resistance when hit by a few drugs at once.

The implications of this find are pretty significant. If drugs can regain their usefulness, then it opens up a whole new range of treatment options that are often far cheaper than the replacement treatments. And when we're talking about millions of lives at stake, this is a pretty big deal.

Technorati: chloroquine, malaria, africa, ddt.