Heeding the WARNing from malaria’s past

As outlined in a series of articles in the online open access publication, Malaria Journal, the World Antimalarial Resistance Network (WARN) aims to provide a globally co-ordinated effort to tackle the disease, which is estimated to kill between 1 and 2.7 million people every year.

One of the major aims of WARN is to facilitate worldwide monitoring and characterisation of drug resistance, particularly that to the latest generation of antimalarial drugs, artemisinin-based combination therapies (ACTs).

WARN will consist of four linked, global, open-access, web-based databases containing four kinds of data:

·Clinical drug efficacy
·In vitro response of malaria parasites to drugs
·Prevalence of molecular markers of drug resistance
·Pharmacological properties of drugs in different groups of patients.
The databases will include freely available tools to make adding information straightforward, and to give researchers the opportunity to analyse and use information from the databases in a variety of ways. Information on individual patients will be collated in a standardised way, which should make it easier for researchers to compare directly or pool data from different sites across the world.

WARN’s founders hope that the databases will help speed up the publication process for scientists. This, in turn, means that policymakers and malaria control managers will have access to timely information on the temporal and geographic trends of drug resistance, allowing them to take action as soon as resistant malaria parasites are detected.

Drug resistance is a major threat to the control and eradication of malaria and can lead to treatment failure, increased spread of the disease, and higher morbidity and mortality. Many ‘old’ antimalarials, including chloroquine and mefloquine, are now of limited use because of drug resistance.

Today, over 50 countries recommend ACTs as first-line therapy for falciparum malaria, the most severe form of the disease. While these newer treatments are currently effective, researchers know that resistance to ACTs will emerge in the future.

The network is being launched after a meeting of leading malaria researchers and policymakers sponsored by the Bill and Melinda Gates Foundation held at the Wellcome Trust/Sanger Centre, Cambridge, UK in late 2006.