Is malaria eradication possible?

Malaria parasites in red blood cells

Nearly three years ago, Bill and Melinda Gates called upon the world to eradicate malaria (Seattle PI).

That upset a lot of people, many of them specialists in malaria, largely because it was regarded as violating Voltaire’s warning against seeking perfection at the expense of the good.

Eradication had long been a taboo word in the malaria field because previous attempts at eradication had failed only to watch the disease come roaring back.

And with those additional failures came even greater loss of confidence in later attempts to control or contain malaria in many poor countries.

As a result, malaria efforts and research fell into a state of neglect. As the Gates Foundation’s Dr. Gina Rabinovich said of the international community: “They didn’t get rid of malaria but they did a pretty good job of getting rid of (malaria research).” And so the malaria parasite has been doing pretty well, even increasing in scope.

Worldwide, the current estimate is that there are anywhere from 250 to 400 million cases of infection and maybe a million deaths (mostly in children) every year.

There are more precise numbers, but the precision is misleading. Malaria’s heavy toll is among the very poor, mostly in Africa, their diseases generally undiagnosed and their deaths undocumented — just like other invisible tragedies of the poor.

Child with malaria, Nigeria (Photo: Tom Paulson)

On Monday, at PATH’s bright, shiny new South Lake Union headquarters, a small and dedicated group of people gathered to celebrate efforts aimed at restoring confidence in the notion that malaria can be beaten.

It was a day too late to officially mark World Malaria Day, on April 25, but who cares?

Monday, it turns out, was actually World Intellectual Property Day, Confederate Memorial Day and Worldwide Pinhole Photography Day.

I’d say the global problem of malaria trumps any of these, on any day.

At the PATH event, several local organizations working to prevent malaria by distribution of insecticide-impregnated bed nets described their successes and ongoing challenges.

Thanks to the work of organizations like PATH, Rotary International, World Vision and many others — especially the Global Fund, which is the major source of funding — working in partnership with governments in Africa, hundreds of millions of nets have been distributed (along with anti-malarial drugs) in the last half decade or so preventing perhaps as many as a million deaths.

But the international community is still nowhere near achieving its goal of “universal coverage” with nets (UNICEF report) and only very few of those needing drugs get them still.

Stefan Kappe, of Seattle Biomed (aka Seattle Biomedical Research Institute), described his team’s work on a malaria vaccine – soon to start testing in human volunteers.

Others talked about the problem of drug resistance, and of the need for a greater and sustained commitment from donors to fully fund efforts to fight malaria.

“The hard work is still ahead of us,” said Dr. Kent Campbell of PATH. The successes so far achieved remain fragile and tentative, Campbell said, but there is now much more evidence that malaria can be beaten even with simple tools like bed nets.

Eradication? The opinion of most experts is that this will be impossible without a vaccine. But the U.S. rid itself of malaria without a vaccine. Other countries have as well.

As Voltaire also said: “Opinions have caused more ills than the plague.”

Tom Paulson covered science, medicine and global health as reporter for the Seattle Post Intelligencerfrom 1987 to 2009, before the print version of the paper closed and PI became the online news site. Now he continues to report as a freelance and blogs about the local global health scene at his website: A Page from Tom Paulson.

Tags: Gates Foundation, Malaria, PATH, Seattle Biomed

Category: Malaria, News