Not necessarily.<p>Current prevalence of resistance to artemisinin is mostly due to what happened shortly after the drugs discovery. That is, wide-spread single-mode-of-action use. This was due to uncontrolled over-the-counter use in South East Asia, which in recent years has been curtailed.<p>While this still happens, the WHO has gotten much much better at making sure combined therapies are used, which is the essential bit to controlling resistance.<p>The only tool we have to combating biological resistance (in any organism) are combined therapies. Doing so hijacks the mathematics of natural selection to make it almost impossible to evolve resistance (given high enough stacks of modes-of-action and complete treatment courses).<p>As the graph in the article shows, artemisinin resistance is still mostly contained to where it originally evolved (cambodia). Given careful management, we can expect slow spread, if any at all.<p>Fighting malaria isn't a one-punch win. It is a marathon, but one that we are very slowly winning. The disease is trending downwards and we are finally making in-roads into the most endemic regions. This slow reduction in the disease burden worldwide makes resistance harder and harder for the parasite to evolve.<p>Drug resistance is deadly serious, but I'm not as pessimistic as this article. Given proper tracking of resistance, and management, we'll easily have several more decades of artemisinin use.
Hm..... There's only two studies in Cambodia, though. One of them apparently had a faillure rate of about 17%, which makes me think the other study had a failure rate of about 5%, to get a median of ~12% seen in the graph. Couldn't the high failure rate in Cambodia just be an artifact of an outlier study? Nearby Laos also has a low failure rate. Unfortunately, I don't see Thailand on the list, which would be another nearby country to compare with...
Since I have family that lives in Zambia and my daughter was there for three months this is scary. Mosquito born diseases kill more people than any other animal on earth. about 600,000 a year.<p><a href="http://www.gatesnotes.com/Health/Most-Lethal-Animal-Mosquito-Week" rel="nofollow">http://www.gatesnotes.com/Health/Most-Lethal-Animal-Mosquito...</a><p>This could go MUCH MUCH higher.
Cambodia is highlighted here, but what isn't mentioned is that is specificially the border region of Thailand and Cambodia. I find that specifically worrying given the amount of travel that Thailand gets from around the world.<p>I remember reading a story a couple years ago of Thais crossing the border into Cambodia where artemisinin was cheap and unregulated, but I can't find it.
Resistance IS a big deal. I've lost my grandfather last monday due to nosocomial pneumonia (essentially, pneumonia resistant to all existing antibiotics).
Johns Hopkins is developing a mosquito where the virus can't be transmitted, secondly the drug was developed in the 50s so the effective life of the drug at only ... only 70 years of use to just show slowness recently. With the research pace, the variation of reintroduced genetics will be less that 10. We are fine.