Options are running out in the race to eliminate malaria before the parasite responsible for the deadly disease completely outsmarts man's last line of resistance -- an herbal drug known as artemisinin.
“There are very few options and indeed there are very few drugs in the pipeline. So, really, we have one shot eliminating this disease," said Benjamin Rolfe, executive secretary of the Asia Pacific Leaders Malaria Alliance (APLMA). "If we don’t eliminate in the next 15 years we will lose our tools, lose our armory and we are very likely indeed, almost certain, to see a resurgence of this disease in the Asia Pacific region and then, subsequently, in the African region.”
Rolfe called the situation "a global public health emergency.”
He spoke with VOA during a break in the two-day meeting in Bangkok of APLMA and the Emergency Response to Artemisinin Resistance (ERAR).
Public health officials are alarmed that the drugs most utilized to combat the most dangerous form of malaria are becoming ineffective in the Greater Mekong sub-region.
"We saw this happen with previous drugs, chloroquine," explains Rolfe. "The resistance spread from this region through India into Africa. And we’re very concerned that that may happen again.”
An area of particular concern is the long India-Myanmar border.
"India has its own very high burden of malaria that has been stubborn in recent years," said Rolfe. "And if resistance spreads through India to Africa we risk seeing many millions of deaths.”
The governments of Australia and Vietnam, in particular, were praised by participants of the Bangkok meeting for showing leadership in the battle to eliminate malaria, but there is concern of a lack of a similar level of commitment from other heads of state.
"Without the investment, without the cash to make this happen, we will fail," Rolfe warned.
APLMA was formed during the East Asia Summit held in Brunei in 2013 amid concern among leaders about the risks of malaria's resurgence, in particular due to increasing drug-resistance in the Greater Mekong area.
Isolated from the sweet wormwood plant, artemisinin and its derivatives have been able to swiftly reduce the number of Plasmodium parasites in the blood of malaria patients.
But the parasite has been found to be resistant to the drug -- considered the last line of defense against malaria -- in parts of five Southeast Asian countries: Cambodia, Thailand, Laos, Vietnam and Myanmar (also known as Burma).
In one area of western Cambodia, near the Thai border, three distinct group of malaria falciparum parasites resistant to artemisinin have been identified, according to research published in 2013 in the journal Nature Genetics.
There were an estimated 198 million cases of malaria worldwide in 2013, and an estimated 584,000 deaths, according to the World Health Organization.
Ninety percent of all malaria deaths occur in Africa where an estimated 437,000 African children died before their fifth birthday due to malaria in 2013.
Between 2000 and 2013 (the latest year for which figures are available) the incidences of malaria were cut by 30 percent globally. And during the same period, malaria mortality rates decreased by an estimated 47 percent worldwide and by 54 percent in Africa.