Heading off fever
researchers at the New York University Medical Centre have recently identified a protein on the surface of the single-celled malaria parasite, Plasmodium , which helps it to invade human liver and blood cells. The find, the second such in the past year, has created ripples of excitement among scientists. An antimalaria 'wonder' vaccine may soon be a reality.
But experience in dealing with the disease cautions that quick-fix solutions are not sustainable. To begin with, the search for 'miracle' vaccines needs substantial funding. It is not sure where this money is going to come from. A Multilateral Initiative on Malaria ( mim ) has been conceived of by the National Institutes of Health, Bethesda, usa , the World Health Organization ( who ) and the World Bank. But World Bank and United Nations ( un) funding alone will not help make the 30-year malaria control programme that it envisages a reality.
Measures to prevent and control malaria in the past hundred years have cost the world billions of dollars. But drugs, insecticides and strategies formulated at the national and global level have failed due to improper implementation, lack of involvement of communities and inadequate analysis of the problem at the local level.
The malaria eradication programmes taken up in the mid-1950s were over-optimistic. After their initial success in controlling breeding of the disease-carrier, the Anopheles mosquito, and the parasite which causes it ( Plasmodium ), malaria made a comeback barely a decade later. The mosquitoes developed an immunity to insecticides like dichloro diphenyltrichloroethane ( ddt ), which were widely used during the 'eradication' era, and Plasmodium became immune to widely prescribed drugs like chloroquine.
Attempts to control 'the second wave' of the disease had limited success, although the climate of opinion was hopeful towards the end of the 1970s. But the optimism was again misplaced. Strains of chloroquine-resistant Plasmodium falciparum , which causes the severe or fatal form of malaria (cerebral malaria), spread further in the 1980s. In the 1990s, agricultural and industrial development projects in rural and urban areas of developing countries led to migration of millions of people to malarious areas, increasing the risk of epidemics. The projects also created ecological changes that favoured transmission of the disease. As a result, death and illness due to malaria either remained stable or increased in these countries.
While new drugs and broad-based vaccines to combat the malaria parasite are being tested, ecological problems are still a challenge. The Second Global Meet on Parasitology with a focus on malaria was held in Secunderabad, India, from August 18-22, 1997. The responses of delegates at the con-ference were mixed, but the consensus was that the scenario for the next ten years is grim. The deliberations at the meet - timed to coincide with a hundred years of discovery of transmission of the malaria parasite - made it clear that if a fresh wave of localised malaria epidemics is to be prevented, consistent effort at the international, national and local level is required.
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