Professor Robert Sinden is head of malaria cell biology at The Jenner Institute, University of Oxford. He will be speaking at the Biology Week Debate: ‘Malaria eradication – Can we do it? Should we do it?’ at the Royal Institution on Thursday 16th October.
Together with HIV and tuberculosis, malaria imposes one of the highest health burdens on mankind. We must keep eradication as the key driver of our research.
There are an estimated 25 species of malaria parasites described in primates. Around five of these species can infect humans, and all of these species are transmitted by 30-40 mosquito species. The majority of human disease and deaths are caused by just two species P.falciparum and P.vivax.
In the 19th century half the world’s population were at risk of malaria and 1:10 died of the infection. In the 20th century, technologies targeting the mosquito vectors, such as housing improvements, bed nets, and insecticides e.g. DDT, along with anti-parasitic drugs such as chloroquine, have reduced global malaria deaths outside of Africa by ~99%.
There are concerns surrounding the emergence of drug and insecticide resistance or avoidance that affects both the parasite and vector (e.g mosquitos). Currently there are significant advances in the discovery of new targets for chemical and biological attack and these new methods could lead to the eradication of these two important parasite species if applied rationally.
To achieve this goal we must reduce parasite transmission between host (e.g. human) and vector (e.g. mosquito). In doing so we should exploit our understanding of the parasites molecular machinery, and newly discovered potential targets for attack, as well as our understanding of anti-parasitic interventions such as vaccines and combination-drugs. We need to use these important technologies in conjunction with key population bottlenecks in the parasites’ life cycles, which have been previously overlooked.
Eliminating malaria could free up funding to be used in different areas of healthcare. However, any elimination campaign would also be accompanied by a campaign to reduce the impact of disease in infected individuals. Of course it is of the utmost importance to eliminate in areas where sustainable technologies permit us to do so, however we should also seek to control spread in areas where elimination may not yet be feasible.
Control in the absence of elimination is an interminable drain on both financial and human resources which, following eradication could be available for other initiatives. One current estimate suggests malaria in Africa alone still costs some $12billion per annum in lost GDP.
Of the limited budget that governments and institutions are prepared to spend on improving quality-of-life nationally and globally, malaria merits targeted funding in proportion to the impact on health/life quality it imposes. However, it is unlikely with current tools that we will eradicate all malaria species found in man worldwide.
Places are still available for the Biology Week Debate: ‘Malaria eradication – Can we do it? Should we do it?’ at the Royal Institution on Thursday 16th October.
Read what fellow speaker Dr Tony Holder has to say: Eradicating Malaria: The evolution problem.