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Back on TRAC: New trial launched in bid to outpace multidrug-resistant malaria

Nature Medicine volume 22, pages 220–221 (2016)Cite this article

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Resistance to artemisinin, the key ingredient in ACT, had already been observed in regions of Cambodia, Thailand, Myanmar, Vietnam, Laos and along the Indian border. Yet until this recent study, reports of ACT failure were exceedingly rare. Nick White, a malaria specialist at Mahidol University in Thailand, stresses the urgency of the situation. “So much effort and money has gone into eliminating malaria in the past few decades, and here is something that could really sink all of that,” he says. He and other researchers fear that ACT failure could become more widespread.

This is the nightmare scenario that malaria experts have fretted about since ACT became the WHO-recommended gold standard in 2001. In general, pathogens naturally acquire mutations that protect them against drugs, so it was only a matter of time before Plasmodium falciparum, the parasite responsible for the malaria deaths worldwide, did just that. In 2006, news of resistance to artemisinin surfaced, and as the situation grew more dire, in 2011, an international team of researchers formed the Tracking Resistance to Artemisinin Collaboration, known as TRAC. The group includes scientists from Mahidol University in Thailand, the University of Oxford, UK, and the Medical Research Council's Center for Genomics and Global Health also in Oxford, among others. The group's first study, completed in 2013, mapped the spread of artemisinin resistance in Southeast Asia2. In November last year, members of the team began to enroll participants in the second TRAC study, a clinical trial called TRAC II. Their chief goal is to find a therapy that can treat people who have multidrug-resistant malaria and no longer respond to ACT.

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  1. Amy Maxmen is a freelance science journalist based in Berkeley, California.,

    Amy Maxmen

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Maxmen, A. Back on TRAC: New trial launched in bid to outpace multidrug-resistant malaria. Nat Med 22, 220–221 (2016). https://doi.org/10.1038/nm0316-220

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