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 Malaria killed about 445,000 people last year, more than 90 percent
of them in sub-Saharan Africa, but the figure has nearly halved
since 2000.
Now the hard-won gains are at risk from the latest drug-resistant
form, which emerged in Cambodia before spreading to Laos, Thailand
and Vietnam.
"What we are concerned about is that a patient with the disease
travels between countries and that risks the spread of infection,"
said Vicharn Phatirat, who heads the mobile disease control unit in
Bo Rai, 300 km (190 miles) east of Bangkok, the capital.
Health officials monitor victims of the mosquito-borne disease
closely, to ensure they complete their treatment, which limits
chances for the disease to become resistant to drugs, as well as to
identify carriers of resistant strains.Still resistance is emerging
in Southeast Asia to the drugs artemisinin and piperaquine, critical
in the fight against malaria, which has seen billions of dollars
spent to help avert infection and cut diagnosis time and costs.
"The parasite strains are spreading quite quickly at the moment
through Cambodia to the neighboring countries," said Arjen Dondorp,
the head of malaria research at Mahidol-Oxford's Tropical Medicine
unit in Thailand.
Scientists fear a repeat of the global malaria resurgence after
drug-resistant parasites emerged in Southeast Asia from the 1950s to
the 1970s.
THAILAND CRITICAL
"The border areas have traditionally been where resistance has
spread," said Seth Berkley, chief executive of the GAVI global
vaccine alliance, explaining why places like Bo Rai have a critical
role in the fight.
No longer as busy as during the decades when it was a center for the
smuggling of Khmer Rouge gems and supplies, it remains a key border
crossing, where 16 malaria cases were detected this year, down from
a peak of 774 in 2002.
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Signs in languages from Burmese to Khmer warn against the danger of
malaria. Foreigners, mostly migrant workers, made up just under a
third of the malaria patients in Thailand last year, government data
shows.
"We cannot fully follow up on them taking the medications properly
as they constantly move across borders," said Thai health official
Vicharn.
Fake or substandard drugs widely available in the region may also
help boost resistance, rather than killing the parasite.
The best way to halt resistant strains is to eradicate the disease,
once endemic across southern Europe and parts of the United States.
Thailand hopes to wipe out malaria by 2024, with fewer than 10,000
cases this year, down nearly 60 percent from 2016.
"We have entered the malaria elimination stage," said health
official Piti Mongklangoon.
(Editing by Clarence Fernandez)
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