As I Begin My Research on Malaria Drug Resistance in Papua, I Urge the World to Stand with WHO

CILEUNGSI, SUBAGIYO -- As a doctoral student from Indonesia about to begin research on genetic mutations related to antimalarial drug resistance, I am both hopeful and deeply concerned. Hopeful---because my research in Kabupaten Mimika, Central Papua Province, will contribute to the global understanding of resistance patterns in Plasmodium falciparum and P. vivax. Concerned---because the global health landscape is shifting in ways that may compromise efforts like mine, particularly the reduction in support for WHO, as recently highlighted in The Lancet's open letter.

My study will focus on mutations in the pfcrt, k13, and dhfr genes---genetic markers associated with resistance to chloroquine, artemisinin, and antifolate therapies. Papua remains one of Indonesia's hardest-hit malaria regions, and there is growing concern over treatment failures and evolving resistance.

WHO's technical frameworks, training, and global genomic surveillance initiatives have long provided essential scaffolding for research such as this. Without WHO's continued involvement and funding, data harmonization, early warning systems, and regional collaborations become fractured. This is particularly worrying for researchers working in geographically and logistically challenging areas like Central Papua.

(Peta Endemisitas Malaria (Sumber: Malaria Kemenkes/Kemenkes))

The downstream implications for clinical pharmacy practice are substantial. As drug resistance patterns shift, pharmacists---especially clinical pharmacists in endemic settings---must adjust treatment protocols, guide rational drug use, and participate actively in antimicrobial stewardship programs. Research like mine provides the molecular evidence base needed for these changes. Without updated surveillance, pharmacists risk relying on outdated regimens, leading to poor patient outcomes and further resistance.

As someone at the beginning of this research journey, I echo the open letter's plea: cutting funding to WHO is not only ethically questionable but scientifically short-sighted. For Indonesia, and for regions like Mimika that continue to battle malaria daily, WHO remains not just a partner---but a lifeline.

Let us not undermine global solidarity in health. Instead, let us invest in it---so that young researchers, frontline pharmacists, and vulnerable communities can all move forward with the knowledge and support they need.