Drug Resistance in Malaria 2020 Report | UPSC

Drug Resistance in Malaria 2020 Report | UPSC


Antimalaria drug resistance not alarming but growing fast, says WHO report

      WHY IN NEWS:

Three states in India’s North East reported resistance to commonly used drug against malaria

SYLLABUS COVERED: GS 3: Reports : Diseases


For PRELIMS go through the parasites and treatment . Make a chart if possible .

For MAINS note down all the potential causes of increasing drug resistance and instances throughout the globe.


Malaria killed 405,000 people in 2018 and affected 218 million people.


  • Fight against this killer is becoming difficult due to the growing resistance against malarial drugs.
  • Risk due to antimalarial drug resistance is not high currently, but can lead to a loss of hard-fought gains,

Artemisinin-based combination therapies (ACTs) are the first and second line of treatment for malaria caused by Plasmodium falciparum.

The role of the artemisinin compound is to reduce the number of parasites during the first three days of treatment.

  • According to the new WHO report, ACTs remain efficacious across the world, by and large.
  • This parasite causes a majority of malarial cases in the WHO’s African and South-East Asian regions, the hubs of the disease.
  • Wherever treatment failures were observed, policy changes were introduced.
  • The five countries in the Greater Mekong Subregion (GMS) including Cambodia, Laos, Vietnam, Thailand and Myanmar have been epicentres of antimalarial drug resistance.


  • Drug resistance in malaria


  • World Health Organisation (WHO)
  • The report, released as part of the ongoing World Antimicrobial Awareness week, was prepared on the basis of studies conducted from 2010-2019.
  • 1,046 studies conducted from 2010-2019 and involving 65,749 patients was analysed for preparing the report.


  • The report says that some ACTs combinations are no more efficacious in the above mentioned epicentre countries.

Four of the six ACTs have become inefficacious in Myanmar, three in Laos and two in the other GMS countries.

  • However, the saving grace is that not all ACTs are ineffective yet and at least two are still working.
  • The mutations in the malarial parasite have been responsible for artemisinin partial resistance.
  • As many as 1,044 studies conducted globally from 2010-2019 confirmed the PfK13 mutation.
  • The highest prevalence of PfK13 mutations was found in the GMS.
  • ‘C580Y’ is the mutation most frequently identified.

ACTs remained more than 98 per cent efficacious in other African countries. 


  • The other common parasite that causes malaria, especially in India, is P vivax.

Chloroquine (CQ) is the most commonly prescribed drug for this parasite.

  • P vivax resistance to chloroquine had been reported from all WHO regions.
  • Antimalarial therapies other than CQ had been deployed to treat malaria cases and they had shown effective results.


36% of the global population live in areas where there is risk of malaria transmission. 

  • Each year an estimated 300 to 500 million clinical cases of malaria occur.
  • This makes malaria one of the most common infectious diseases worldwide.
Drug Resistance in Malaria 2020 Report | UPSCSOURCES : WHO 
  • Malaria transmission occurs primarily in tropical and subtropical regions in sub-Saharan Africa, Central and South America.
  • The disease is also prevalent in the Middle East, the Indian subcontinent, South-East Asia, and Oceania.


  • In humans, malaria infection is caused by one or more of four species of intracellular protozoan parasite.

Plasmodium falciparum, P. vivax, P. ovale, and P. malariae differ in geographical distribution.


Direct microscopic examination of intracellular parasites on stained blood films is the current standard for definitive diagnosis.

  • Simple light microscopic examination of Giemsastained blood films is the most widely practised
  • A second method is a modification of light microscopy called the quantitative buffy coat method is also used.


  • Resistance to antimalarial drugs has been described for two of the four species of malaria parasite that naturally infect humans.

P. falciparum and P. vivax. P. falciparum has developed resistance to nearly all antimalarials in current use.

  • Although the geographical distribution of resistance to any single antimalarial drug varies greatly.


  • Disparate issues as human behaviour
  • Vector and parasite biology
  • Pharmacokinetics, and economics.
  • Conditions leading to malaria treatment failure .


Chloroquine remains the drug of choice for treatment of non-falciparum infections and non-severe falciparum infections. 

  • Drug resistance is not an all-or-nothing phenomenon, chloroquine still retains adequate efficacy.

Drug Resistance in Malaria 2020 Report | UPSC


  • The report noted – Tripura, Arunachal Pradesh and Mizoram had shown that the parasite had become resistant ‘artesunate and sulfadoxine-pyrimethamine (AS+SP) combination’.

In the rest of India, AS+SP failure rates were less than 10 per cent.

  • These states have shifted to using artemether-lumefantrine .
  • All other states which show resistance to the AS+SP combination will have to make this move.
  • In India, 28 different mutations had been detected in the studies conducted in the last ten years.


  • A widespread resistance scenario could emerge on the basis of a study of hypothetical scenarios .

Considering, all malaria endemic areas experienced a 30 per cent treatment failure rate with ACTs.

  • This would result in a yearly excess of 22 million treatment failures, 116,000 deaths .
  • The costs include an estimated $130 million to change treatment policy.

      IASbhai WINDUP: 


  • Imperfect coverage of antimalarial drugs, improper diagnosis, misuse of drugs and not-so-good mosquito control programmes were cited by the report.
  • We should support new drug development. Investigate new approaches to drug delivery.

These failures lead to increased exposure of the malaria parasites to drugs, increasing the risk of drug resistance.

  • Up-to-date, quality data are needed on the efficacy of the recommended treatments, to ensure that patients receive efficacious treatment.
  • Investigation should happen how a combination therapy strategy could be financed.
  • Last but not the least, We need to improve access to and use of definitive diagnosis-based treatment.
     SOURCES:  DownToEarth  | Drug Resistance in Malaria 2020 Report | UPSC



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