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Fight against malaria at the border between Myanmar and Thailand
2014


The meandering Moei, which marks the natural boundary between Thailand and Myanmar, is also the staging ground of the most important frontline in the worldwide battle against malaria.

Malaria is the work of the single-celled Plasmodium parasites, and Plasmodium falciparum chief among them. They spread between people through the bites of mosquitoes, invading first the liver, then the red blood cells. The first symptoms are generic and flu-like: fever, headache, sweats and chills, vomiting. If the parasites spread to the kidneys, lungs and brain, things go downhill quickly. Malaria already kills around 660,000 people every year, most of them in Africa.

François Nosten came to Thailand in 1983. He worked for Médecins Sans Frontières and treated refugees from Myanmar in camps along the Thai border. His encounter with Nick White, a British clinician, changed his life. He found out how harsh the fight against malaria is, in a region where Karen people, third ethnic group of Myanmar, were fleeing persecution from the predominantly Bamar government. Together they created malaria research units in Bangkok and in the refugee camp of Shoklo.
At that time, malaria was the biggest killer in the region, and options for treating malaria were running out. In 1994, Artemisinin changed everything. Since then, “cases have just gone down, down, down,” says Nosten. “I’ve never seen so few in the rainy season – a few hundred this year compared to tens of thousands before.”

Yet, the parasite responsible for malaria has started to develop resistance to Artemisinin. Without radical measures, resistance will spread to India and Bangladesh. Once that will have happened, it will be too late.

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