We’ve come a
long way since the days of blaming the stars.
Malaria has
terrorized humankind for thousands of years, but for most of that time, we had
no idea what caused it. The ancient Greeks thought Sirius the dog star might be
responsible. A Chinese medical text from 270 BCE speculated that three demons
spread
the disease. As recently as the mid-1800s, doctors believed malaria was
caused by the stinky fumes that wafted into cities from nearby swamps (the
word malaria means “bad air” in Italian).
Today, we
know exactly who our enemy is: the mosquito. Doctors no longer subject malaria
sufferers to unpleasant (and pointless) treatments like blood-letting and
chewing tree bark. Most importantly, we’ve made massive progress in fighting a
disease that as recently as 2000 killed nearly 870,000 people in a single year.
This
progress is one of the most remarkable global health stories in recent years.
Malaria claimed more than 429,000
lives last year, mostly in Africa and Southeast Asia. While that
figure is still way too high, it represents a 50 percent reduction overall from
the disease’s peak in the early 2000s. I don’t throw the word “miracle” around
lightly, but that number is nothing short of miraculous.
How did we
get here? I give credit to an unprecedented scale-up in global commitment and
cooperation—malaria funding rose by 1,000 percent from 2000 to 2015. This money
fueled a number of amazing scientific breakthroughs, enabled us to deliver them
at scale, and focused more brainpower on improving both control and treatment
efforts.
This October
marks a decade since Melinda and I first called for eradicating malaria. It was
a controversial move at the time, but the progress made since then has
convinced many that this is a realistic goal (although some are still
skeptical).
If I had
known back in 2007 how much progress we would make in ten years, I would’ve
been thrilled by how much we’ve cut the death rate. I’d also be impressed by
how many insecticidal bed nets are now in use, how new treatments are helping
people with the most severe cases of malaria, and how rapid diagnostic tests
have made it easier to find and treat people. But it wouldn’t all be good news.
In 2007, I
thought we’d have a long-lasting malaria vaccine by now. The WHO plans to
begin pilot demonstration projects of a first-generation
malaria vaccine in sub-Saharan Africa next year, although without a booster
dose it only protects a child for less than six months. I’m hopeful that
researchers will develop a next generation vaccine that offers much longer
protection within the next 10 years, but a decade ago I was overly optimistic
about where we’d be today.
There are
still plenty of reasons to believe we can eradicate malaria, though. In the war
against malaria and the mosquitos who carry it, we’re already fighting on every
front. Consider the wide array of innovations in development right now:
o
New Insecticide-Treated Bed Nets: The older generation of bed nets needed
to be soaked in a special insecticide solution every six months. The
long-lasting nets we will distribute in Mozambique through our giveaway protect
people from mosquitoes for three years and can even be washed when they get
dirty. Unfortunately, some mosquitoes are now developing resistance to the
pyrethroid insecticides used in these nets—so researchers are working on next generation bed netsthat use combinations of
insecticides and appear effective against all mosquitoes, including
insecticide-resistant ones.
o
Tackling Drug Resistance: In Southeast Asia, we’ve seen some types of the
malaria parasite develop resistance to the drug combinations we use to cure and
prevent the disease. If this drug resistance spread to Africa, it’d be a
disaster. Fortunately, we have partners on the front lines finding ways to
fight back. Watch this VR video about the amazing work one team of researchers
is doing to combat drug resistance in Thailand:
o
Disease Mapping: We know
more today about where malaria is occurring than we have at any other
point in history. Public health experts are combining anonymous data from
mobile phone records with data on malaria incidence to track the movements of
infected mosquitoes. That's super valuable, because it helps countries use
their limited resources in places that have the highest disease burden.
o
Eave Tubes: Many houses in hot climates have a gap between the roof and
the walls to keep the inside cool. By sealing these gaps and inserting
special tubes just
below the roofline, air still flows into the house but keeps mosquitoes out
with a mesh filter. Since the tubes are too high for children to reach them,
the mesh can be coated with a high enough dose of insecticide to kill even
insecticide-resistant mosquitoes.
o
Genome Editing: Our foundation has invested a lot of money into editing the genetic code of mosquitoes. We’re still in
the very early stages of development, but scientists are
exploring whether this technique could one day render a small number of key
mosquito species infertile or unable to carry the malaria parasite.
o
Attractive Targeted Sugar Baits: Only female mosquitoes bite people, and
they only do it when they’re breeding. The rest of the time, they rely on sugar
for energy. These calendar-sized
trapshang on the outside of homes and contain a minimum risk toxin that
kills more than 95 percent of the mosquitoes that flock to their sweet scent
without affecting pollinators. Trials are underway in Mali.
I think we
will see an end to malaria in my lifetime. It’s a preventable and curable
disease, and the public health community has already demonstrated that it’s
possible to shrink the map and save lives. These new tools in the development
pipeline will play a huge role in reaching our goal. While we’re still
decades away from wiping malaria off the map for good, one thing is clear: the
mosquito has met its match.’
Africa Center for Clin Gov Research &
Patient Safety
@ HRI West Africa
Group - HRI WA
Consultants in
Clinical Governance Implementation
Publisher: Health and
Medical Journals
8 Amaku Street Housing
Estate, Calabar
Cross River State, Nigeria
Cross River State, Nigeria
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