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Mosquitoes bite back

Observations on malaria

Just over a month ago, I reported in these pages on a surge in optimism in the fight against malaria, thanks to unprecedented investment in drug development and new ways to combat one of the world’s most pervasive infectious diseases. There had just been a pledge of £150m to subsidise the purchase and distribution of the best class of antimalarial drug, artemisinin combination therapies, or ACTs. These compounds have steadily replaced cheaper drugs such as chloroquine and antifolates as the parasites that cause malaria have developed resistance to them.

Sadly, reports now indicate that in Cambodia parasites are taking longer to clear when treated with ACTs, too. It would seem that resistance has also emerged to artemisinin. The parasites are still cleared by the combinations, but after five days of treatment, rather than the usual two.

International anti-malaria policy has, for several years, recommended that artemisinin be administered in combination with at least one other antimalarial for precisely this reason. A genetic mutation of the disease that offers resistance to one of the drugs should be countered by the second. This does indeed appear to be happening in Cambodia – so what is the problem? It had been naively hoped that artemisinin itself was such a potent compound that malaria parasites would find it difficult to develop resistance. But evolution ensures that resistance to any antimalarial compound will occur eventually.

In principle, it should be possible to block the spread of artemisinin resistance. The aggressive introduction of other drugs, mosquito control and the use of insecticide-treated bed nets in those areas where resistance has emerged could obliterate the resistant strain. The World Health Organisation, with financial support from the Bill and Melinda Gates Foundation, is already attempting to cleanse those parts of western Cambodia where artemisinin resistance has emerged. But it remains worrying that the resistance has emerged at all. Much of the optimism that we might actually be able to eliminate malaria has been built
on the concept of combinations using artemisinin.

The resistance that ultimately rendered earlier drugs obsolete also emerged from the Cambodian-Thai borderlands before spreading to other parts of the world. In the case of artemisinin, it is distressingly clear why this region has become an incubator for such a selection of drug-resistant malaria parasites. Health services are poorly regulated, and in spite of WHO recommendations, people can buy antimalarial drugs in their local markets. Artemisinin on its own is cheaper than an ACT: simple economics dictates that it will be used by itself, rather than in combination. Even cheaper are fake drugs, packaged in replica boxes indistinguishable from the real thing. Small amounts of the real drug are often added to the fakes, so that any tests show the drug to be present. Sublethal doses of drugs create the perfect conditions for the parasites to mutate.

The notion that fake versions of drugs desperately needed to save lives are flooding the marketplace seems repugnant. However, with 300 million victims each year and half the world’s population living in malarious regions, the antimalarial market is sufficient to stimulate such activity. While medical science offers solutions to malaria, socio-economic factors continue to thwart efforts to eliminate this scourge.

This article first appeared in the 15 June 2009 issue of the New Statesman, Tragedy!

Photo: Getty Images
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When will the government take action to tackle the plight of circus animals?

Britain is lagging behind the rest of the world - and innocent animals are paying the price. 

It has been more than a year since the Prime Minister reiterated his commitment to passing legislation to impose a ban on the suffering of circus animals in England and Wales. How long does it take to get something done in Parliament?

I was an MP for more than two decades, so that’s a rhetorical question. I’m well aware that important issues like this one can drag on, but the continued lack of action to help stop the suffering of animals in circuses is indefensible.

Although the vast majority of the British public doesn’t want wild animals used in circuses (a public consultation on the issue found that more than 94 per cent of the public wanted to see a ban implemented and the Prime Minister promised to prohibit the practice by January 2015, no government bill on this issue was introduced during the last parliament.

A private member’s bill, introduced in 2013, was repeatedly blocked in the House of Commons by three MPs, so it needs a government bill to be laid if we are to have any hope of seeing this practice banned.

This colossal waste of time shames Britain, while all around the world, governments have been taking decisive action to stop the abuse of wild animals in circuses. Just last month, Catalonia’s Parliament overwhelmingly voted to ban it. While our own lawmakers dragged their feet, the Netherlands approved a ban that comes into effect later this year, as did Malta and Mexico. Ringling Bros. and Barnum & Bailey Circus, North America’s longest-running circus, has pledged to retire all the elephants it uses by 2018. Even in Iran, a country with precious few animal-welfare laws, 14 states have banned this archaic form of entertainment. Are we really lagging behind Iran?

The writing has long been on the wall. Only two English circuses are still clinging to this antiquated tradition of using wild animals, so implementing a ban would have very little bearing on businesses operating in England and Wales. But it would have a very positive impact on the animals still being exploited.

Every day that this legislation is delayed is another one of misery for the large wild animals, including tigers, being hauled around the country in circus wagons. Existing in cramped cages and denied everything that gives their lives meaning, animals become lethargic and depressed. Their spirits broken, many develop neurotic and abnormal behaviour, such as biting the bars of their cages and constantly pacing. It’s little wonder that such tormented creatures die far short of their natural life spans.

Watching a tiger jump through a fiery hoop may be entertaining to some, but we should all be aware of what it entails for the animal. UK laws require that animals be provided with a good quality of life, but the cruelty inherent in confining big, wild animals, who would roam miles in the wild, to small, cramped spaces and forcing them to engage in unnatural and confusing spectacles makes that impossible in circuses.

Those who agree with me can join PETA’s campaign to urge government to listen to the public and give such animals a chance to live as nature intended.


The Right Honourable Ann Widdecombe was an MP for 23 years and served as Shadow Home Secretary. She is a novelist, documentary maker and newspaper columnist.