Tell me a bit about yourself.

I’m trained as an infectious diseases and intensive care physician, and developing ICU [intensive care unit] care in developing countries is an interest of mine. I’ve been living here, in Bangkok, for the last 15 years. During that time, I’ve mainly been doing research on both uncomplicated and severe falciparum malaria, a disease that requires intensive care in hospital. Over the last ten years or so, I’ve developed a strong interest in antimalarial drug resistance, which is an increasing problem here in the region – again.

Despite recent declines in the number of cases worldwide, malaria remains a public health concern with 3.2 billion people still at risk of infection globally. [1] Fortunately, malaria is a treatable disease - artemisinin is an effective and potent drug recommended for treatment of uncomplicated malaria cases in most parts of the world. However, the success of this frontline drug is threatened by emerging resistance.

Resistance to the widely used antimalarial drug artemisinin is spreading in Southeast Asia and is likely to be around the corner for Africa. It could reach us very quickly or it could emerge locally.

We don’t want to be surprised by it and we don’t want to be banging our heads against the wall trying to figure out how to deal with it when it comes. We need to be prepared.

I heard her cries before I saw her. Rita* is a slight girl, maybe eight years old, and she has malaria. In this part of West Africa – a far northern corner of Ghana, near the border with Burkina Faso – the most likely culprit is the parasite Plasmodium falciparum that causes the deadliest type of malaria.  Rita emerged from the clinic: teary-eyed, exhausted, miserable. She walked slowly and unsteadily beside her mother, and then dropped to the floor and vomited.