DISARMING MALARIA As the first children receive a dose of malaria vaccine in a new phase III clinical trial, other researchers are hard at work making genetically modified mosquitoes and interpreting satellite data to keep this prevalent killer at bay.
DAVE POLAND/PATH MALARIA VACCINE INITIATIVE

Despite having been subdued in many parts of the world by the 1970s, malaria—and the mosquitoes that spread it—has come back in force, now killing at least a million people worldwide each year. An efficient illness, the parasite has become largely resistant to the popular drug chloroquine, and many mosquitoes have similarly developed resistance to the pesticide DDT. Most of its casualties are children, and of the hundreds of millions who survive the disease, many are left disabled and vulnerable to reinfection from the parasite's liver-dwelling cells.

Searching for a way to solve such a prevalent problem has led researchers to take a variety of approaches, ranging from using satellite data to map weather conditions to tampering with the DNA of the mosquitoes themselves.

Diseases based on a zoonotic (animal-to-human) vector, including malaria and other killers such as hantavirus, require a nuanced understanding of the transmission cycle. "You have to understand the vector, you have to understand its habits, you have to understand the local cultural setting," said Phil Thuma, managing director of the Malaria Institute at Macha (MIAM) in Zambia, in a video presentation shown during a Johns Hopkins Malaria Research Institute (JHMRI) summit on Thursday.

By hunting for a wide range of ways to keep malaria at bay, researchers are hopeful that they can finally vanquish the killer that has likely plagued humans for at least tens of thousands of years. "It's important for us to have an arsenal of control methods," said George Dimopoulos, an associate professor of molecular microbiology and immunology at JHMRI, at the summit. "We can only control malaria through a combination of a variety of approaches."

Aside from scientific advances, however, other societal progress is needed in many places. Reduction of poverty and increased access to health care may help spread basic preventive measures such as malarial screening and bed nets treated with pyrethroid chemical insecticides. Political instability is yet another roadblock to reaching many of those who need it most. "There are political situations in the world today where one can't go in and set up a hospital," said Gregory Glass, a professor of epidemiology and of molecular microbiology and immunology at Johns Hopkins Bloomberg School of Public Health. "Until we can resolve that, we're not going to be facing eradication."

Sungano Mharakurwa, scientific director of MIAM, for one, is "optimistic that one day our institute will be obsolete."

Slide Show: Squashing Malaria: Advances in Research and Prevention