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The world’s number-one treatment for malaria is on the brink of failure because of a new strain of drug-resistant parasites — unless health policymakers take action. Professor Sir Nicholas White says that the mosquito-borne parasite responsible for severe malaria is now showing resistance to the prime treatment, Artemisinin Combination Therapy (ACT), across South-East Asia. If this resistance jumps to Africa, he warns, the tragedy will be on a massive scale.
A just war on bugs? Ethical differences between antimalarial resistance and antibacterial resistance
Posted 15/08/2025. In this commentary, Phaik Yeong Cheah and colleagues argue that antimalarial resistance and antibacterial resistance raise distinct ethical considerations. Unlike antibacterial resistance, mitigating antimalarial resistance has well-defined goals and does not involve environmental factors or the use of livestock. These differences make it clear that not all microbes should be addressed in the same way, and that interventions must be tailored accordingly.
Bioethics and Engagement
The Bioethics and Engagement Department is central to MORU’s mission of conducting impactful health research in low-resource settings. Its efforts ensure that research is conducted ethically, inclusively, and in close partnership with the communities and other stakeholders who are affected by our research. The Bioethics and Engagement team coordinates activities across Thailand, Laos and Cambodia.
Use of the International Classification of Diseases to Perinatal Mortality (ICD-PM) with verbal autopsy to determine the causes of stillbirths and neonatal deaths in rural Cambodia: a population-based, prospective, cohort study
Posted 08/08/2025. Perinatal cause-of-death data in low-resource settings are scarce. Applying the WHO's new ICD-PM classification system to verbal autopsy data in rural Cambodia, Kaajal Patel and colleagues identified hypoxia, prematurity, and infection as leading causes. We found that adaptations to ICD-PM were needed to better classify deaths, especially when the timing of death was unknown.
Handheld Spatially Offset Raman Spectroscopy for rapid non-invasive detection of ethylene glycol and diethylene glycol in medicinal syrups
Posted 06/08/2025. Pavel Matousek, Paul Newton and colleagues from the Medicine Quality Research Group developed a portable laser-based method, SORS, to detect toxic contaminants in medicinal syrups without opening bottles. This innovation addresses the urgent need for accessible screening, following deadly contamination incidents in Asia and Africa. The technology enables rapid, non-invasive testing across supply chains to improve medicine safety.
Comparative virulence analysis of seven diverse strains of Orientia tsutsugamushi reveals a multifaceted and complex interplay of virulence factors responsible for disease
Posted 17/07/2025. Scrub typhus, caused by Orientia tsutsugamushi, varies in severity depending on the bacterial strain. Jeanne Salje and colleagues compared seven strains in mice and found no single predictor of virulence. Instead, disease severity results from multiple bacterial genes influencing immune responses. These findings could inform future vaccine development and diagnostics.
Single low dose primaquine to block the transmission of Plasmodium falciparum—proposed stand-alone and ACT-adapted regimens
Posted 16/07/2025. At long last and almost 13 years since the WHO recommendation, we now have evidenced-based regimens of single low dose primaquine to block the transmission of Plasmodium falciparum and help eliminate artemisinin and partner drug resistant malaria which is currently spreading rapidly across eastern Africa and beyond. By Bob Taylor
Why should we be concerned by internalised racism in global health?
Posted 15/07/2025. Internalised racism is an overlooked concept that can shape how professionals from historically marginalised backgrounds see themselves within global health. This essay by Bipin Adhikari and colleagues offers a space for reflection on how deep-rooted racial hierarchies may quietly influence identity, behaviour, and institutional culture. Advancing equity in global health also means understanding how these patterns take hold within us.
Evaluation of the Wondfo G6PD/Hb Test for glucose-6-phosphate dehydrogenase deficiency: preliminary performance, matrix equivalence, and usability
Posted 25/07/2025. Increased availability of validated G6PD tests can enhance diagnostic capacity in LMIC for vivax radical cure and neonatal health. This preliminary evaluation of a new point-of-care G6PD quantitative test showed excellent performance in frozen and fresh samples collected in Thailand (SMRU) and USA. A WHO pre-qualification study is now ongoing in Brazil and Thailand. By Germana Bancone
Optimization of heat inactivation protocols for Orientia and Rickettsia species
Posted 30/07/2025. Stuart Blacksell and colleagues evaluated heat inactivation of Orientia tsutsugamushi, Rickettsia typhi, R. conorii, and R. honei at 56 °C, 80 °C, and 90 °C for varying times. All were inactivated at 56 °C for 5 minutes. O. tsutsugamushi showed greater reduction, with time–temperature effects differing by species, highlighting important pathogen‑specific heat‑treatment requirements for biosafety purposes.
Over the counter use of topical corticosteroid for skin conditions among patients before attending skin specialist clinic in Nepal: A qualitative study
Posted 29/07/2025. Why do many patients arrive at skin clinics only after their conditions worsen, despite early treatment? This study from Nepal reveals how over-the-counter steroid use, informal networks, convenience, and customary practices shape care-seeking for skin conditions. These factors also mirror patterns seen in over-the-counter antimicrobial use. By Bipin Adhikari.
Risk factors and mitigation strategies of laboratory-acquired infections in research and clinical laboratories worldwide: a systematic review
Posted 01/08/2025. Causes of laboratory‑acquired infections and pathogen escapes are often under‑reported. A review from 2000–2024 identified 712 cases and 17 deaths. Common incidents included needlestick injuries and PPE failures. Research laboratories reported more decontamination issues, while clinical laboratories faced sample‑handling risks. These findings support targeted improvements in laboratory risk management practices. By Sandhya Dhawan
Pneumococcal density and respiratory co-detection in severe pediatric pneumonia in Laos
Posted 03/06/2025. Worldwide, acute respiratory infection is the leading cause of morbidity and mortality in children. The first study in Laos on respiratory pathogen co-detection was conducted at Mahosot Hospital and confirmed an association between pneumococcal density and influenza but not between respiratory syncytial virus and severe pneumonia in children less than 5 years old. By Audrey Dubot-Peres and Sue Lee.
Hide and seek with falsified medicines: Current challenges and physico-chemical and biological approaches for tracing the origin of trafficked products
Posted 28/05/2025. The trade in falsified medical products is a major public health threat and also a huge, profitable business. Despite detection methods, tracing their origin remains difficult. Cathrin Hauk and colleagues explore analytical techniques adapted from other fields such as food, drug, and wildlife investigation to help identify their sources and empower enforcement efforts.
Genetic surveillance of Plasmodium falciparum populations following treatment policy revisions in the Greater Mekong Subregion
Posted 27/05/2025. The GenRe-Mekong project analysed 5,982 Plasmodium falciparum samples in the Greater Mekong Subregion (2017–2022), using genetic surveillance to inform malaria control. A sharp decline in piperaquine-resistant strains followed drug policy changes, highlighting how real-time genetic data can support timely, evidence-based responses to shifting malaria threats. By Varanya Wasakul
Operational evaluation of the deployment of Malaria/CRP Duo and Dengue Duo rapid diagnostic tests for the management of febrile illness by village malaria workers in rural Cambodia
Posted 23/05/2025. Village malaria workers in rural Cambodia provide essential early diagnosis and treatment; however, their importance is diminishing following a significant decline in malaria. James Callery and colleagues explore the potential expansion of their roles to ensure that febrile patients continue to utilise their services until local malaria elimination is achieved and the risk of reimportation subsides.
A comparison of national seasonal influenza treatment guidelines across the Asia Pacific region
Posted 21/05/2025. Seasonal influenza remains a major health burden in Asia. Our new comparative analysis reviews national influenza treatment guidelines across Asia Pacific countries, finding significant variation in availability, rigour, and recommendations. Our findings reveal key opportunities to strengthen evidence-informed, systematic guideline development as part of national and regional influenza preparedness and response. By Ellen Beer.