|Top Malaria Experts Publish Groundbreaking Research
to Aid Malaria Eradication Efforts
NIH Leads Effort to Present Collection of Latest Discoveries
Leading research scientists, physicians, and public health specialists
from around the world have published new insights into the international
burden of malaria and how the global community can best combat
the disease, it was announced today by malaria experts at the Fogarty
International Center, part of the National Institutes of Health.
The collection of the latest research is presented in a 340-page
supplement to the American
Journal of Tropical Medicine and Hygiene titled "Defining
and Defeating the Intolerable Burden of Malaria III: Progress and
Perspectives." The supplement contains 42 articles and features
a diverse range of contributors, including epidemiologists, entomologists,
microbiologists, economists and social scientists.
Every year about 500 million people become severely ill with malaria
and over one million die from the disease, according to the World
Health Organization (WHO). In Africa, the WHO estimates one in
every five childhood deaths is due malaria, with a child dying
from the disease every 30 seconds. Malaria accounts for about 40
percent of public health budgets in some countries and lowers economic
growth by reducing workforce productivity and increasing poverty.
"Malaria control will never be successful if we declare victory
when rates go down and success seems at hand," said Dr. Roger
I. Glass, M.D., Ph.D., director of the Fogarty International Center
at NIH, which spearheaded the supplement. "Sustainability
will require the training of local staff to continue the scientific
and administrative leadership of prevention and treatments efforts,
and adequate preparation so they can monitor and address any outbreaks."
"The extraordinary advances highlighted in this valuable
publication reflect a new commitment by the international community
to confront malaria with fervor and funding," says Anthony
S. Fauci, M.D., director of the National Institute of Allergy and
Infectious Diseases (NIAID), part of the National Institutes of
Health (NIH). "As a result of recent research, we now have
new drugs that are highly effective in treating malaria, new and
improved vector control strategies, and a widening pipeline of
promising vaccine candidates. Even so, much remains to be done."
The groundbreaking publication — available free to scientists,
researchers, and other interested parties worldwide — details
the latest developments on a broad range of malaria issues. Significant
Transgenic Mosquitoes and the Fight Against Malaria: Managing
Technology Push in a Turbulent GMO World
Gene modified organism (GMO) technology, if applied to mosquitoes,
offers unique opportunities for controlling malaria by reducing
transmission of the disease, according to a team of scientists
from Austria, the Netherlands and Kenya. Even though insecticide
treated nets (ITNs) are now widely used, insecticide resistance
will continue to increase, necessitating alternative vector control
strategies, according to the authors. Integrative approaches are
needed to move genetic control trials forward with the greatest
chance to properly assess the merits in terms of public health
benefits. Resolving transitional and implementation challenges
may prove more complex and time consuming, but they will ultimately
determine the power of transgenic mosquito development, according
to the paper's authors.
New Interventions for Malaria: Mining the Human and Parasite
The sequencing of the human genome provides a new opportunity to
determine the genetic traits that confer resistance to malaria
infection, as detailed by a team of international scientists. The
identification of these traits can reveal immune responses, or
host-parasite interactions, which may be useful for designing vaccines
or new drugs. The parasite genome sequence is currently being explored
to accelerate the development of new antimalarial interventions
— for example, identifying parasite metabolic pathways that
may be targeted by drugs. The genome sequence of the malaria parasite
P. falciparum and its human host create new opportunities to solve
the malaria problem.
Microbially Derived Artemisinin: A Biotechnology Solution
to the Global Problem of Access to Affordable Antimalarial Drugs
Despite considerable efforts by multiple governmental and non-governmental
organizations to increase access to artemisinin-based combination
therapies (ACTs), these life-saving antimalarial drugs remain largely
unaffordable to the most vulnerable populations. A new collaboration,
described by a group of California researchers, is setting out
to develop synthetic ingredients to help decrease the cost of the
high price of these treatments. The project has the potential to
reduce malaria mortality rates and to decrease the pervasiveness
of counterfeit drugs. By providing the market with safe, low-cost
ACTs, potential profits generated by criminal counterfeiting activities
could be substantially lowered.
When is "Malaria" Malaria? The Different Burdens
of Malaria Infection, Malaria Disease, and Malaria-Like Illnesses
Misdiagnosis of malaria is common in the identification of uncomplicated
disease and in the diagnosis of severe or complicated malaria.
Overdiagnosis is common in high-transmission areas and underdiagnosis
is common in areas with little or no transmission, according to
researchers in Ghana and Malawi, who collaborated on this paper.
The implications of this inaccuracy could potentially have a significant
impact on clinical and research outcomes. Measurement of the malaria
burden requires careful distinction between different meanings
of the term "malaria" and recognition of the difficulties
of measuring the presence and the effects of parasites. Malaria-specific
mortality is difficult to measure correctly because the disease
is most common in remote areas without the resources necessary
to make definitive diagnoses. The authors suggest more specific
identification and categorization of malaria would improve treatment
of patients and monitor the impact of control measurements.
Additional papers explore malaria advocacy efforts and international
cooperation, examining the gains made by the Multilateral Initiative
on Malaria and the Global Fund, and making recommendations for
a long-term vision for global malaria prevention and control.
"Advocacy for malaria prevention, control and research requires
a holistic view of the disease and an understanding of the socioeconomic
and political circumstances in which malaria exists — malaria's
agenda must at least coordinate, if not merge, with a broader,
encompassing global health agenda," according to James Herrington,
Ph.D., coauthor of an advocacy paper and director of Fogarty's
international relations division.
The third in a series, the new supplement contains data contributed
by malaria researchers from around the world, including many in
malaria-endemic areas. It was edited by Dr. Joel Breman, from Fogarty,
Dr. Martin Alilio, from the Academy for Educational Development
(formerly of Fogarty), and Dr. Nicholas J. White, a distinguished
professor of tropical medicine at Mahidol University in Bangkok,
Thailand and Oxford University in England.
Multiple donors funded the supplement, including the Fogarty International
Center and the National Institute of Allergy and Infectious Diseases — both
of the National Institutes of Health — the Centers for Disease
Control and Prevention, and the Foundation for the National Institutes
of Health with unrestricted contributions from the Bill & Melinda
Gates Foundation, the Burroughs Wellcome Fund, GlaxoSmithKline,
and the World Health Organization.
Full text of the supplement can be accessed by visiting: http://www.fic.nih.gov/news/press_releases/malaria_eradication1-08.htm
Printed copies or CD-ROMs of the supplement are also available
by contacting Cherice Holloway at firstname.lastname@example.org or
The Fogarty International Center, the international component
of the NIH, addresses global health challenges through innovative
and collaborative research and training programs and supports and
advances the NIH mission through international partnerships. For
more information, visit www.fic.nih.gov.
The National Institutes of Health (NIH) — The Nation's
Medical Research Agency — includes 27 Institutes and
Centers and is a component of the U.S. Department of Health and
Human Services. It is the primary federal agency for conducting
and supporting basic, clinical and translational medical research,
and it investigates the causes, treatments, and cures for both
common and rare diseases. For more information about NIH and
its programs, visit www.nih.gov.