The Shoklo Malaria Research Unit (SMRU) was established in 1986 as a centre for epidemiological study into the treatment and prevention of resistant malaria among refugee camps on the Thai-Burma border. At the time, malaria was the most serious health problem facing the displaced population living along the border and the primary cause of death, representing over 45% of out-patient consultations.
Currently 130,000 people live in refugee camps along the Thai-Burma border. The work carried out by SMRU over the past 20 years has improved therapeutics for malaria and relegated malaria from being the single most important medical problem in these camps, to a rare cause of illness and death amongst refugees.
Researchers at SMRU continue to monitor, treat and control malaria, both within the camps and amongst the communities of Burmese migrant workers, who live outside the camps.
It’s one of the most stunning things to say that this little mosquito kills almost a million people every year. Most of those deaths are from malaria. We study mosquitoes in the lab where we grow them, and researchers, volunteers taking their own arm in and feeding them with their own blood. One of the partners and foundations we work with is the Shoklo Malaria Research Unit in Thailand.
When you are infected with malaria, you can take drugs that clear it from your body. Our best drug, artemisinin combination therapy ACT, unfortunately right now in Southeast Asia we are seeing resistance emerge. And that's very scary because if that mutation left Southeast Asia and moved to Africa, in the place where most malaria deaths take place, and where these new drugs being so valuable, they will stop working. A child experiencing cerebral malaria is an awful thing to watch because their brain is being damaged, and they have seizures, and you have to move very quickly. I’ve been in those wards, you can see the sweatiness, that incredible fever that the child’s experiencing.
Along the Myanmar Thailand border, many people work in the forest. These workers often are bringing malaria back at home. One thing that's confusing about malaria, is if you've been exposed enough, your symptoms go way way down, yet we want to cure those people, so that they're not a source of the disease. We've got a team of health workers called the malaria elimination task force, and they are on the frontline. They’re trying to find the cases and treat everyone.
I'm Gilles Delmas, I’m the director of the Malaria Elimination Task Force. Years ago, there were lots of malaria cases. Anybody around here would have several malaria attacks in a year, sometimes more than one a month. The situation has got much better, and the transmission is much lower than what it was. The problem is that the medicines we're using now to control malaria, to treat the patients, are showing signs of resistance, and we know that within the next two to five years, the medicines we’re using now will be useless.
So the world is investing in these workers in Southeast Asia to go find malaria and get rid of it. If we can get rid of it there, it won't have a chance to spread to other locations. We reach out to the people and communities, creating health post workers. These are people who don't have medical training, they're just local villagers who volunteer to help out with this effort. They receive kits with the diagnostic equipment, and the local people trust them. They know them and if the test comes back positive, they'll be able to give them the drugs immediately. In the areas where malaria parasite factions are very very hot, or even asking some villages all of the people there to take the drug to clear out the malaria. If we do it with the right coverage level, malaria will die out in that region. If we do this well, we’ll stop drug resistant malaria from spreading, and we’ll learn how you can get rid of malaria in villages, and use that on a global basis.
There’s just so many mosquitoes.