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 more than 1 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, MD, PhD, 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, MD, 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 papers include:
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 Genomes
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, PhD, 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.
Source: National Institutes of Health