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http://www.radioaustralia.net.au/international/radio/program/pacific-beat/malaria-experts-to-gather-in-sydney/1036912



Delegates from around the region will gather in Sydney next week for a conference called Malaria 2012: Saving Lives in the Asia Pacific.
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Malaria experts to gather in Sydney (Credit: ABC)
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The conference comes at a time when concern is growing over the spread of a drug resistent strain of the malaria parasite. James Gilling, Australia's recently appointed Ambassador for HIV/AIDS, TB and Malaria, says there is an urgent need to accelerate the drive to tackle malaria on a regional basis.

Presenter: Richard Ewart

James Gilling, Australia's Ambassador for HIV/AIDS, TB and Malaria

GILLING: Well, we hope that we're going to get an agreement to ways of building better methods for fighting malaria in the region and that's the point to get the region working as one to attack this disease.

EWART: Does that suggest that at this stage at least the coordination is not all you would wish it to be?

GILLING: Coordination is good. I think there's always opportunities to improve it. Basically the point is you can't fight Malaria on a country-by-country basis. Malaria is born by mosquitoes and mosquitoes cross borders.

EWART: So how do you think the situation can be better managed? I mean what are the perhaps one or two obvious indicators that need to be looked at?

GILLING: There's several things. I think the first thing is that we need stronger, high level monitoring of malaria control and that means having regional leaders, ministers, scientists, who are championing the issue of malaria. We need to look at better targeting of the malaria work, and in particular, that means looking at the drug-resistant malaria and we also need better medicines for the work in the region.

EWART: You mentioned drug-resistant malaria there. I mean that surely must be the number one concern perhaps at the moment, that the drug-resistant strains seem to be spreading far and wide?

GILLING: Yeah, that's right. It's not far and wide. It's still in a relatively small part of the Mekong region, but the threat of it spreading is certainly there and if it does break out, I mean we could be looking at hundreds-of-thousands more deaths a year from Malaria.

EWART: Is it very well understood as to how this drug-resistant strain has come about?

GILLING: It's pretty well understood. We are funded together with the World Health Organisation earlier this year, a review of this issue of drug-resistant and it's basically two or three things. The first thing is people not completing their full course of treatment. It's also a poor quality medicines and it's the fact that we've got quite transitory groups, moving from Malarial to non-malarial parts of the region.

EWART: And is part of the problem compounded by the difficult of access to medication in certain parts of the world and the whole issue of cost and, of course, drug manufacturers copyright.

GILLING: Look, I think it starts with the issue of solid diagnosis, because poor people, which is what we're dealing with, Malaria is above all a disease that affects poor people, don't have the luxury of taking tablets on the hunch that there might be something wrong, so I think the first thing we need to treat is diagnosis. The second thing, you're absolutely right. We need a better access for better medicine and I think we're making some progress there, but I think, as I say, at the regional level, better collaboration can see the region produce more consistent, better quality drugs.

EWART: So as part of what you could achieve at this conference, would that be a move towards a collective drive, if you like, to getting drugs to the people and trying to get around this issue, above all, of cost?

GILLING: In some ways, cost isn't the biggest issue. It costs less than a cup of coffee to treat malaria, bed nets cost $1.40, a course of medicine is just 40 cents. I think the bigger issues are consistency of drug quality. And again now, I think we just have to make sure that across the region, manufacturers come together and ensure that we are developing a consistent quality of drugs.

EWART: By coincidence, there are reports surfacing today as suggesting researchers in London and in France have identified a way to kill the parasite that causes Malaria and they believe a potential treatment that could eradicate Malaria might not be so very far away. Now, of course, we've heard this before. I mean should we be anymore encouraged this time than on previous occasions?

GILLING: Look, I think we should always be encouraged that we've got researchers working on it. Our main point is that we need more researchers working on it to develop better products and improve the programs that we've got. So this is good news of good research, but I think as you suggest in your question, we're still some distance from having a replacement to the main front line drug that controls malaria in the region, and that's Artemisinin, and that is, of course, our big worry that there's an emerging resistance to that drug.

EWART: It's tempting, of course, whenever malaria is talking about perhaps paint a slightly bleak picture, but we should also point out that there's been successes, for example, such as in Solomon Islands, in Vanuatu, where there's been quite a marked reduction with Australia very closely involved with that?

GILLING: That's exactly right. We've spent 37 million dollars specifically focusing on malaria control in Papua New Guinea, Solomon Islands and Vanuatu since 2007 and we've reduced cases in Vanuatu by two thirds, in Solomon Islands, we now just have 50 cases per 1,000 people and it used to be pretty much 200 per thousand people. So that's a 75% reduction. So we are having success, that's exactly right. But we still need to be vigilant, because drug-resistance threatens those gains and that's why we have the conference.