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US Promotes Active Surveillance in Global Fight Against Malaria

  • Jessica Berman

Children living in the Thai-Burma border come to a malaria clinic to get tested in Sai Yoke district, Kanchanaburi Province, October 26, 2012.

Children living in the Thai-Burma border come to a malaria clinic to get tested in Sai Yoke district, Kanchanaburi Province, October 26, 2012.

In the 13 years since the United Nations first marked April 25 as World Malaria Day, dramatic progress has been made in preventing, controlling and treating this deadly tropical disease. Experts believe that with improved surveillance and more diligent treatment efforts, the disease could be soon be eradicated. The U.S. Centers for Disease Control and Prevention, or CDC, is playing a major role in those malaria eradication efforts.

The CDC, headquartered in Atlanta, conducts scientific research and provides technical support to countries around the world on how to deal with malaria, a leading cause of illness and death in many of the countries affected by this mosquito-borne disease.

"The CDC has documented that in some of these communities, one out of every four medical visits of children was for malaria. One out of every two units of blood used for transfusion was for malaria. And in communities where they have implemented good control measures, we’ve seen essentially zero cases of malaria with good control and zero deaths. So we know tremendous progress is possible,” said Tom Frieden, director of the CDC.

But in 10 countries with the highest incidence of malaria, experts say more resources are needed to prevent a resurgence of the illness.

Testifying before the U.S. Congress this week on his agency’s role in global disease eradication, Frieden said the challenge in the fight against malaria, which in Africa alone kills one child every minute, is staying one step ahead of the malaria parasite.

Frieden cited the need for better public health surveillance, and urged Congress to fund better detection tools.

He held up for lawmakers a diagnostic computer chip capable of separating and then sorting through the billions of "letters" in the malaria microbe’s genetic alphabet, giving doctors critical information in a mere four hours.

“There are actually more than 10 million individual wells on this chip. We can take the fragments of DNA and with the supercomputer, put them back together like a jigsaw puzzle with tens of thousands of pieces to figure out where the connections are, whether it’s resistant, how it’s spreading and whether it’s becoming more virulent,” Frieden said.

Other challenges in the war on malaria, according to Frieden, are developing effective malaria vaccines and maintaining the integrity of artemisinin, the most effective drug available to treat malaria. The parasite has developed resistance to other drugs that used to be considered certain cures for the disease.

But some 30 percent of malaria cases in Southeast Asia now show evidence of resistance to artemisinin. Virtually every new drug in the pipeline, according to the CDC director, is either an artemisinin-related product or synthetic artemisinin, and if malaria treatment programs are not well-organized and controlled, the effectiveness of these new drugs also could be compromised.

So, Frieden told members of Congress, a critical weapon in the war on malaria is ensuring that artemisinin is used wisely so it continues to be effective.

“I think you can think of drug resistance and prevention of drug resistance as something we owe the world, we owe our children. If these antibiotics that we’ve been bequeathed by people who worked so hard to come up with them are preserved, they can be used to protect lives for many years going forward,” Frieden said.

Frieden added that eradicating the mosquito-borne illness by 2015 will require unflinching policy commitments and sustained funding by the international community.