PAHO/WHO to support Guyana and Suriname in studies of resistance to artemisinin-based combination therapy (ACT)

Guyana and Suriname have announced they will carry out new studies to confirm whether anti-malarial treatments are losing their effectiveness in their populations, as suggested by preliminary data collected by the two countries.

The new studies will be supported by the Pan American Health Organization/World Health Organization (PAHO/WHO), the United States Agency for International Development (USAID), the U.S. Centers for Disease Control and Prevention (CDC), and other partners in the Amazon Malaria Initiative/Amazon Network for the Surveillance of Antimalarial Drug Resistance (AMI/RAVREDA).

Guyana and Suriname made the announcement during the 12th annual meeting of AMI/RAVREDA, which took place in Lima, Peru, on 8-11 April 2013.

The new confirmatory studies were urged by a group of technical experts from AMI/RAVREDA partner agencies that was convened by PAHO/WHO on 21 February 2013. The experts analyzed data recently collected by Guyana and Suriname on the efficacy of artemisinin-based combination therapies (ACTs), which are used as first-line treatment for infections caused by the Plasmodium falciparum parasite.

The expert group included representatives from the Ministry of Health of Guyana, the Ministry of Health of Suriname, PAHO/WHO, USAID, CDC, and the WHO Technical Expert Group on Antimalarial Drug Resistance and Containment. The study results and the expert team's conclusions were then presented to the Malaria Policy Advisory Committee, which met in Geneva on 13-15 March 2013.

Based on the data, which included results from the verification of microscopy slides, the expert group concluded that initial findings in Guyana and Suriname could be an early sign of declining artemisinin efficacy in the locations studied. They recommended a set of rigorous follow-up studies to be conducted to clarify the situation.

In addition to supporting the new confirmatory studies in Guyana and Suriname, PAHO/WHO, USAID, and AMI/RAVREDA partners will continue to collaborate closely with ministries of health in all malaria-affected countries to scale up efforts to control and eliminate the disease. Efforts will need to be strengthened to roll out malaria interventions in the Americas region, including increasing the deployment of vector control tools, expanding access to quality-assured diagnostic testing and antimalarial treatment, and stepping up disease surveillance.

PAHO/WHO urges its member countries to implement the comprehensive set of technical recommendations contained in the Global Plan for Artemisinin Resistance Containment (GPARC), to follow the specific PAHO/WHO guidance on the subject (see links below), and to embrace the T3: Test, Treat. Track initiative launched by WHO Director-General Margaret Chan in April 2012.

PAHO/WHO will continue to raise awareness globally about the dangers of emerging artemisinin resistance and the acute funding gaps faced by malaria-affected countries, preventing a timely response to the challenges posed by emerging antimalarial drug resistance.