Improved treatment for severe malaria saves more lives

Promising news from the field of malaria research in 2010 shows that treating children suffering from severe malaria with injections of artesunate could save many more lives.

Malaria kills around one million people every year, with nine in ten deaths being in young African children.  Severe malaria – which is marked by serious symptoms such as coma, convulsions, or difficulty breathing – progresses rapidly and is particularly deadly.  Those who manage to survive are often left with life-long neurological damage.

Severe malaria is still mostly treated with the drug quinine, while uncomplicated malaria is treated with drugs containing derivates of artemisinin, an extract from a Chinese plant.  In early 2010, the World Health Organization (WHO) strongly recommended that adults with severe malaria be treated with artesunate, a derivate of artemisinin, because it is more effective and has fewer side effects than quinine.

Now, the results from a large trial in nine African countries provide the strong evidence that children would also benefit from the newer drug.  MSF is already treating severe malaria in children with a drug derived from artemisinin and will now widely introduce artesunate. Artesunate should be used to treat both adults and children with severe malaria so that many more lives can be saved.  

But wider obstacles remain: WHO treatment recommendations have yet to be revised in light of the latest evidence in children, and most countries have yet to recommend artesunate in place of quinine for either adults or children.  And international donors have yet to put their full weight behind the latest evidence.

Dr. Martin DE SMET, Coordinator of MSF’s Malaria Working Group “We now have the proof that fewer children will die from severe malaria when we use artesunate injections instead of quinine.  And high-quality artesunate is now available from reliable sources that have been validated by the World Health Organization.  So we have the evidence and we have the tools, but the challenge now is a quick roll-out of this treatment in Africa.”