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Scientists Claim Hard-Fought Ground Against Malaria

Kanya D'Almeida

WASHINGTON, Apr 25 2011 (IPS) - By the time the reader gets to the end of this paragraph, an African child, likely under five years old, will have died from malaria.

Discussing this grisly epidemic at a press conference honouring the fourth annual World Malaria Day via teleconference, Dikembe Mutombo, the legendary basketball player- turned health champion hailing from the Democratic Republic of the Congo (DRC) said Monday, “Africa has already lost a million to HIV/AIDS. Now we are losing millions more to malaria – a whole generation of doctors, teachers and future leaders. This must end now.”

Huge global efforts are currently underway to halt the disease, which has infected over 225 million people and claims nearly 800,000 lives every year, according to recent statistics from the U.N. children’s agency UNICEF. Ninety percent of these deaths occur across the continent of Africa, with the majority of victims being infants and pregnant mothers.

Leading the battle are the U.S. Agency for International Development (USAID), the Gates Foundation and British pharmaceutical giant GlaxoSmithKline, which along with other organisations remain hopeful that the killer can be beaten.

USAID administrator Rajiv Shah said here Monday, “Five years ago, malaria killed nearly one million people each year – most of them children. In Africa alone, the burden of the disease cost the continent 12 billion dollars a year in lost productivity. Today we help save nearly 150,000 lives every year.”

Though World Malaria Day has hitherto been a somber moment in which to take stock of the scale of the crisis, the theme for this year appears to have moved from solemnity to almost celebratory.

In his exuberant presentation to reporters at the Foreign Press Center Monday, Eric Tongren, Center for Disease Control and Prevention (CDC) liaison to the Presidential Malaria Initiative (PMI), cheerfully informed reporters that efforts to curb the epidemic were fast gaining ground.

Though he acknowledged that a child in Africa dies from the disease every 45 seconds, that 40 percent of annual healthcare expenditure in the continent is squandered on treating a disease that has long been eradicated in most of the West, and while mourning the 12-billion- dollar economic loss to governments due to the epidemic, Tongren congratulated the various global campaigns that are inching towards their goal.

At the top of the priority list of the global effort has been a battle to prevent infection in new mothers and their young children, who between them comprise the world’s most vulnerable population. The Maternal and Child Health Integrated Program (MCHIP), the USAID Bureau for Global Health’s leading maternal, neonatal and child health (MNCH) effort, aims to reduce mortality rates by 80 percent in the hopes of achieving Millennium Development Goals 4 and 5 within the decade.

Koki Agarwal, MCHIP’s director, said here Monday that malaria kills more children than any other disease in the world and accounts for close to eight percent of infant deaths.

A key contributor to PMI – President Barak Obama’s ambitious five- year-plan backed by a two billion dollar budget – MCHIP aims to halve the deaths in 15 of the worst-affected countries by providing supplies and coverage to 85 percent of the at-risk populations, particularly through the use of insecticide-treated mosquito nets (ITNs), long-lasting insecticide-treated nets (LLINs), indoor residual spraying and the wide use of anti-malarial drugs.

However, little mention was made about the flaw in this plan to eradicate the disease, namely, mosquitoes’ increasing adaptability and resistance to the insecticides used to keep them at bay.

Most LLINs are sprayed with Pyrethroid, the only chemical substance that has thus far been positively identified to work effectively on nets, deterring mosquitoes from feeding at night. Over the years mosquitoes have adapted quickly and efficiently to overcome the challenge, either by changing feeding patterns, or actively resisting insecticides at the cellular level.

“A considerable number of studies have found that, depending on location, anywhere from 25-50 per cent of all malarial mosquitoes are resistant to Pyrethroid,” Stephen Buhner, a New Mexico-based science author and researcher, told IPS.

“Some studies have shown that even after an hour and a half of exposure to the insecticide, mosquitoes were unaffected by it. In fact it took three and a half hours to generate a 50 percent mortality rate,” Buhner added, “so it’s clear these creatures are developing resistance at a fairly rapid rate.”

Mosquitoes have what is called a cytochrome (P460) system, which according to Buhner allows them to deactivate insecticide even after it has been ingested, allowing them to completely convert the insecticide into a harmless metabolite.

“This is the same phenomenon that we have been witnessing in agricultural pests,” Buhner said. “There currently exist about 500 different insect pests that have become resistant to insecticides; this is an inevitable dynamic.”

Away from the spotlight of the cheerleaders for malaria eradication, little-known groups of scientific researchers are hard at work finding radically different alternatives that dive straight to the root of the crisis at hand.

The Research Initiative on Traditional Antimalarial Methods (RITAM) publishes extensively on the importance of moving closer to traditional medical care, particularly the use of herbal alternatives to increasingly resistant antibiotics.

Initially created by the Global Initiative for Traditional Systems (GIFTS) of Health – funded by the Rockefeller Foundation and WHO’s Tropical Disease Research (TDR) division – RITAM enables much-needed collaboration between practitioners, researchers and physicians committed to bringing back traditional approaches to preventing and treating malaria.