Government introduces new drug for malaria in resistant areas

Leony Aurora , The Jakarta Post, Jakarta

The government has introduced a new drug to counter malaria nationwide, starting with 14 regencies and municipalities where parasites causing the disease have been found resistant to the medication used over the last decade.

Minister of Health Achmad Sujudi said after opening a workshop to introduce the new drug to health agencies on Monday that plasmodium falciparum, one of the types of malaria, had mutated because of indisciplined usage of the currently-used drug chloroquine, locally known as kluorokin.

"For example, they (patients) should take three tablets at once, but they take only one, three times a day," said the minister.

The new drug artemisinin was imported from China, said Sujudi. "As it is produced from plants, we are conducting a feasibility study on the cultivation of such plants here in Indonesia," he added.

The detected resistant regencies and municipalities are Simaulue in Aceh, South Lampung in Lampung, Kulonprogo in Yogyakarta, Purworejo and Banjarnegara in Central Java, Landak in West Kalimantan, Pasir in East Kalimantan, East Sumba and Alor in East Nusa Tenggara, Central Halmahera in North Maluku, Minahasa in North Sulawesi, Mimika in Central Irian Jaya and Jayapura (both the regency and the municipality) in Papua.

Two other provinces that are predicted to face the same problem are Maluku and Jakarta, but no solid proof has been established yet to confirm this.

"We are concerned that non-resistant areas will become resistant soon because of people's high mobility," said Director of Communicable Diseases Umar Fahmi Achmadi.

Two areas, Banjarnegara and East Sumba, had conducted pilot projects on the use of a combination of artesunate, which contains artemisinin, and amodiaquine, and they showed good results, Achmadi added.

According to a preliminary report on the pilot project in East Sumba, 94.4 percent of the 21 patients on which the medication was tried recovered. Side effects caused by the drugs include nausea and headaches.

Achmadi said that in the future, the usage of drugs containing artemisinin would be supervised by village malaria monitoring agents or public health centers. Regions will be urged to rejuvenate their inactive or defunct malaria monitoring agencies, he added.

For malaria, the government has set a target to cut the mosquito-borne disease's incidence rate to half of the base line -- the rate in 2000 -- by 2005. The government has allocated Rp 30 billion (US$3.49 million) this year for malaria eradication.

The Malaria incidence rate declined from 0.81 per 1,000 population in Java and 31.09 per 1,000 outside Java in 2000 to 0.47 per 1,000 population and 22.3 per 1,000 respectively in 2002.

Nevertheless, Indonesia has seen better times in malaria management. In 1997, the incidence rate in Java stood at 0.12 per 1000 population and outside Java at 16.06 per 1,000.