Each year malaria infects up to 500 million people worldwide. More than a million succumb to the deadly disease, most of them children. For years the medical community combated the disease with chloroquine--a cheap, effective drug that did much to alleviate the situation. But chloroquine-resistant malaria emerged and spread over the next few decades. Today resistant strains flourish in Asia, Africa and South America. Research reported in the October 20 issue of the journal Molecular Cell, however, may eventually change that. According to the new study, scientists have identified the gene that makes the malaria parasite resistant to chloroquine. The finding could facilitate efforts to develop drugs to treat the disease. Furthermore, it could allow for the return of chloroquine itself.
Because the malaria parasite took a relatively long time to develop chloroquine resistance, investigators had suspected that many genes were involved. But Thomas Wellems of the National Insitute of Allergies and Infectious Disease and his colleagues found that, in fact, only between four and eight mutations in a single gene dubbed pfcrt determine whether the parasite line is resistant or not. Considering that, the team believes it might be able to tweak the chloroquine composition so that it will work against the parasite once more.
In related news, the latest updates on other antimalarial tactics are described in the October 20 issue of the journal Science. The outlook is encouraging: within five to 10 years scientists think they will have a successful malaria vaccine. And before that a Chinese herbal remedy known as artesunate may be made available. Yet as new resistant strains arise, positive results can't come soon enough.
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Add CommentMALARIA RESPONSE: why developing countries are failing and what can be done about it?
Reply | Report Abuse | Link to thisUnfortunately, rising expectations and broad support for the vision set forth in the Millenium Declaration (New York, September 2000) have not always resulted in more efficient and effective responses to malaria. Inherent in this fact is explicit recognition that providing a strong sense of direction to the malaria response requires a set of specific and context-sensitive reforms that resonate with the challenges of today and prepare for those of tomorrow.
Indeed, the focus of these reforms goes well beyond restricted approaches and cuts acrossn the established boundaries of the health sector. For instance, health-care delivery programmes cannot be developed in isolation from ambitious sanitation policies, better governance and further leadership. This implies a stark departure from the linear and top-down/bottom-up models of the past. Other shining and striking example: to date - although we live in an increasingly global context -, the Ministries of Health in most sub-Saharan African countries still serve as unique advocacy and policy tools for developing malaria-related strategies. In many regards, this anachronistic situation can no longer be a viable option or solution. If shortfalls in performance are to be redressed, the malaria response of today and tomorrow will require stronger collective management guided by a clearer sense of overall direction and purpose.
In matter of addressing malaria, developing countries need credible alternatives to health-care delivery programmes (among many). Shortly, reforms aimed at improving the response to malaria are neither primarily defined by the component elements they address, nor even by the simple choice of a package of interventions to be scaled up, but by the environmental, social and political dynamics that make populations vulnerable to malaria seen as challenging development issue. That, in the final analysis, is the chief reason why I campaign for a Malaria Observatory (1,2,3) in my native country (Congo-Brazzaville, Central Africa). Once established, this likely innovative structure should be entrusted with the responsibility for networking connecting actors and converging sectors around a shared agenda.
Doctor Michel ODIKA (Congo-Brazzaville)
1. Malaria Observatory (Slide presentation available at https://www.slideboom.com/presentations/183737/Malaria-Observatory).
2. Advocacy for a Malaria Observatory in Congo-Brazzaville (http://www.booksie.com/health_and_fitness/article/michel_odika/advocacy-for-a-malaria-observatory-in-congobrazzaville/nohead/pdf/ver/8).
3. Malaria response at a cross-roads (http://www.nature.com/news/report/index.html?comment=14594&doi=10.1038/news.2008.1133).