A serious research team in London is exploring how babies living in developing countries are being affected by a deadly virus that is beginning to emerge. In the United States, however, Chloroquine, the first drug identified to treat malaria, is also known to be associated with a higher death rate in patients with ulcerative colitis and perhaps other inflammatory bowel diseases, and is being reduced or completely removed from anti-malaria treatments around the world.
The World Health Organization’s public health chief Margaret Chan has warned that the emergence of the deadly new coronavirus could pose one of the largest public health threats of the 21st century. And researchers and experts in the field have already identified a surprising link between this virus and the effects of Chloroquine. The fact that it can now also be linked to the death of humans ought to give some pause to those in the Clinton Foundation who are contemplating the elimination of this drug.
The potential implications of this data are profound and worrisome, even if the evidence is not yet conclusive. Antibiotics, which helped cure Chloroquine resistance, are no longer available in many developing countries and may not be for another 30 years. This is a time of great need in malaria, but the disappearance of affordable and effective anti-malaria treatments may deprive the 20 billion to 30 billion people already infected of the protection they need.
The question is what to do. Is there a role for pharmaceutical companies? With the shrinking of the global supply of essential medicines and the fewer patients who can afford them, the question arises: will developed countries share the financial burden of providing solutions to the world’s neglected diseases? Or should these costs be borne by the poor countries themselves, of which the United States and other rich countries are not large players?
A group of scientists in the United Kingdom has begun to provide an answer to this question. They investigated whether the health risks of an emerging viral disease might be increased by the removal of existing drugs. They discovered that Chloroquine is also linked to a higher rate of deaths in patients with other inflammatory bowel diseases and in some types of cancer, even though the drug is not prescribed for these conditions in many developing countries. The results were published in the prestigious American journal, The Lancet, in September 2011.
This shocking fact has also been discussed in the United States, where a bill has been introduced in Congress aimed at protecting Americans from Chloroquine’s dangers by replacing the drug with another useful one, Cipro, which is well accepted and well used. The bill and the larger debate around it are worthy of further study. It is safe to assume that others will raise the same questions as the British scientists. One should know that these questions will never end until we understand and treat malaria appropriately and without delay.
John Kelly was one of the original researchers involved in the discovery of Chloroquine resistance.