malaria epidemic is one of the greatest public health challenges today. Despite
some advances, the disease remains a major killer. A child dies of malaria
every 30 seconds, most of them in Africa.
American Association for the Advancement of Science (AAAS) has been holding a
series of forums here in Washington on what they call "global
challenges," and as we hear from VOA's Art Chimes, this week they focused
on the challenge of "solving the malaria epidemic."
journalist Joe Palca, who moderated the event, noted that 15 years ago, the
disease got little attention in the American press.
contrast, a database search of just three major U.S. papers in the past three
months turned up 120 mentions of malaria.
that's not to say that each one of those was a major take-out kind of story,
but I think that, at least to me, represents the difference between now and 15
years ago – or at least in a crude way I think it does – and maybe that will
help explain why people are actually talking about eradicating malaria
eradicating malaria – like smallpox was eliminated in the 1970s – is
theoretically possible, but for several reasons it's a much more challenging
one, says Ripley Ballou of the Bill and Melinda Gates Foundation, there is not
just one malaria parasite.
are two predominant species that cause the vast majority of infections that
afflict humans – Plasmodium falciparum and Plasmodium vivax, and they are very
different parasites. And a tool, a
vaccine for one will not work for the other. They have different treatment
regimens that are required. And the reality is, we do not have those tools
today, and that's one of the big areas of ours and others' science
the life cycle of malaria is complex. That's good, because the chain can be
broken anywhere as the parasite moves from mosquito to human. You can kill
mosquitoes with insecticide or stop them from biting, for example with bed
nets. But as Ballou points out, efforts at eradication have ultimately failed
because it's hard to get it right.
during this process, the mosquito became resistant to the insecticides, the
parasite became resistant to the drugs, and the resources that were brought to
bear in the eradication program were not sustainable," Ballou explained.
"And I think the combination of those three things led to the failure [of
the eradication effort] and then the sense that it was hopeless."
AAAS forum also included Steven Phillips, medical director for oil company
ExxonMobil. Africa is a major oil-producing region, and Phillips notes that the
company has some 4,000 employees there. "And a quick-and-dirty risk
assessment showed, surprisingly, that malaria was the number one risk faced by
Phillips says that in Africa, an estimated 60 to 80 percent of all malaria
cases are not treated by a doctor or other health professional. And many people – children, usually – are getting malaria drugs even though they don't have
malaria, because the disease is hard to diagnose. Phillips says it's
counterproductive to use malaria drugs except to treat malaria.
you're going to wind up treating people that don't have malaria with drugs that
are going to not only breed resistance, but you're not going to treat the real
problem. And so one of the reasons that one out of five children in Africa do
not reach the age of five is because, when they have a fever, they either go
undiagnosed or presumptively treated for something that they actually don't
means a correct diagnosis is important. Traditionally, that involves a trained
laboratory worker examining a blood sample under a microscope. An alternative,
rapid diagnosis test has been developed, costing less than a dollar. Phillips
describes it as being something like a home pregnancy kit.
a little finger stick and a drop of blood that's put on to a strip, and then
there's a colorimetric assay that changes colors that's pretty easy to
experts say the rapid diagnosis test isn't as good as the traditional,
microscope-based diagnosis, and Phillips says the World Health Organization
isn't convinced yet, either. That has limited the test's widespread deployment.
strategy that has proved to be effective is insecticide-treated bed
nets. Steven Phillips says his company got directly involved in a novel program
to distribute the bed nets in four countries where ExxonMobil operates a total
of 2,000 service stations.
pregnant mother would go to an antenatal clinic. She'd be given a voucher that
would give about two-thirds off of a long-lasting bed net. She would then
present that voucher to a local service station, and she would have a reliable
supply – along with health education materials – from an Exxon service
battle against malaria is important because the stakes are so high, as Ripley
Ballou of the Gates Foundation points out.
hundred million people around the world are infected with malaria every year,
and somewhere between one and three million deaths [occur], most of these in
children under the age of five. There are places where it has been eliminated,
but not very many of them, so we really are talking about a global