STEVE INSKEEP, HOST:
An anti-malaria drug that has saved millions of lives may be losing its effectiveness. In Africa, where many children are at risk, medical professionals are worried. NPR's Gabrielle Emanuel reports on a new study in the medical journal JAMA.
GABRIELLE EMANUEL, BYLINE: Ruth Namazzi is a pediatrician at Mulago Hospital in Uganda. She says a couple times a day, she admits a child with severe malaria. This can mean a high fever, convulsions, anemia.
RUTH NAMAZZI: They can't stand or feed on their own. So these are very critically ill children.
EMANUEL: Then Namazzi does what she's been doing for years. She gives these patients one of the most effective malaria medications available, a drug called artemisinin.
NAMAZZI: It works like magic.
EMANUEL: Artemisinin is derived from an ancient Chinese malaria treatment that was rediscovered several decades ago and has made a profound difference. But lately, the magic of this drug hasn't been working as well. Usually, artemsinin kills most of the parasites in the patient's blood within hours. But now doctors are seeing patients where it takes the drug several days to work. Namazzi says colleagues are stopping one another in the hospital ward with worried looks.
NAMAZZI: People are talking, you know, malaria is very stubborn. It's not responding to treatment.
EMANUEL: She wanted to understand why. So she teamed up with colleagues and launched a study. Chandy John from Indiana University School of Medicine is a co-author.
CHANDY JOHN: What we found was that children with severe malaria do have evidence of drug resistance.
EMANUEL: Meaning some of the patients had a malaria parasite that had mutated to resist the medication. On top of that, researchers also found signs of resistance to a second malaria medication that kids are sent home with. About 10% of the patients that doctors thought were cured showed up sick again within a month.
JOHN: So the combination is supposed to get rid of malaria, but we didn't actually completely get rid of it.
EMANUEL: He says this is scary because kids with severe malaria are the most likely to die from the disease. And even if they survive, they often suffer long-term damage - kidney damage, brain damage. They need a drug that works fast. Kasturi Haldar is at the University of Notre Dame and has been studying malaria for decades. She was not involved in this study, but she says the findings are very concerning but not entirely surprising.
KASTURI HALDAR: This is quite similar to what has happened in Southeast Asia, where there has been clinical resistance to these drugs.
EMANUEL: She says the answer might be adding another malaria medication to the standard treatment, or finding a new drug.
HALDAR: But the development of a new drug is a very long process.
EMANUEL: There is one thing giving doctors hope. In the past few years, malaria vaccines have become available. It's now a race against the clock to control malaria before it develops more resistance to malaria medications.
Gabrielle Emanuel, NPR News. Transcript provided by NPR, Copyright NPR.
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