Border dispute threatens spread of drug-resistant malaria
Cambodian soldiers stationed at the UNESCO site.
Concerns about the effect of the ongoing Thai-Cambodian border dispute on the containment of drug-resistant malaria echoes the broader issue of clashing political agendas and global health initiatives. Conflict began when Thailand was accused of violating Cambodian territory, specifically near this 11th century temple recently declared a UNESCO World Heritage site. The dispute centrally concerns the former Khmer Rouge and its stronghold of the border province Pailin, recognized as the epicenter for drug-resistant malaria since 2009, when it was noted that in some villages parasite clearance took twice the expected time. Along the border there is increasingly drug-resistant malaria that may defeat artemisinin, the most effective drug used for treatment. Officials fear that after becoming completely resistant to artemisinin, the parasite will jump to Africa and transform from a regional issue to a global health disaster. Given limited access for surveillance, early diagnosis, and treatment caused by the conflict, generation of artemisinin-resistant malaria is not unlikely. Last month, WHO rolled out a global containment initiative that will ultimately cost US$175 million. WHO is communicating with both Thai and Cambodian government health administrations but the release of medical information is restricted due to perceived security concerns. Hopefully the escalating conflict can be put on hold before a future without millions of malarial deaths is truly lost.