<ul><li>How big a problem is malaria in the first decade of the 21 st century? </li></ul><ul><li>Calls for a new era in malaria eradication </li></ul><ul><li>Lessons from the previous attempts to eradicate malaria </li></ul><ul><li>The flow of scientific knowledge amongst participants in the struggle </li></ul><ul><li>The role of scientific publishing houses </li></ul><ul><li>The importance of training and supporting endemic country scientists </li></ul>Knowledge as a weapon in the struggle against malaria in sub-Saharan Africa Dr Colin Sutherland London School of Hygiene & Tropical Medicine & Hospital for Tropical Diseases
How big a problem is malaria in the first decade of the 21st century? P. falciparum malaria has contracted from some areas where it was prevalent in the 1990’s. The situation for the other 3 globally-distributed species is unclear. A fifth species, P. knowlesi , is restricted to SE Asia where its natural hosts (macaques) are found.
Calls for a new effort to eradicate malaria in the 21 st century “ Bill and I believe that these advances in science and medicine, your promising research, and the rising concern of people around the world represent an historic opportunity not just to treat malaria or to control it—but to chart a long-term course to eradicate it. We know that the word "eradication" is troubling to many people with deep knowledge of malaria. It's an...audacious goal—to reach a day when no human being has malaria, and no mosquito is carrying it. This is a long-term goal; it will not come soon. But to aspire to anything less is just far too timid a goal for the age we’re in. It's a waste of the world's talent and intelligence, and it's wrong and unfair to the people who are suffering from this disease.” Melinda Gates, Malaria Forum, Seattle, October 17, 2007
Eradication of malaria in the 20 th century Success Success Success Failure
Eradication of malaria in the 20 th century – What went wrong? Strategies successful here … … were not effective here. Failure Success Success Success
Why do some believe we can eradicate malaria in the 21 st century? In the last 10 years, renewed international investment in research and malaria control in endemic countries has generated optimism New intervention strategies have delivered substantial public health benefits A new cohort of scientists, clinicians and public health experts are being trained in malaria research and control
A challenge for eradication strategies: In highly endemic countries, severe malaria occurs in only a small proportion of children infected with Plasmodium falciparum
A reduction of 86.3% in the incidence of clinical episodes of malaria, in a study of 1200 children in Senegal, using IPTc. Badara Cisse et al ., 2006. Lancet 367: 659 – 667.
Child mortality in a West African population protected with insecticide-treated curtains for a period of up to 6 years. Diallo DA et al. 2004. Bull World Health Org 82: 85–91.
How can we make sure the knowledge needed to eradicate malaria in the 21 st century reaches the people who need it? FUNDAMENTAL RESEARCH >>>>>> Malaria research community FIELD RESEARCH >>>>>> Malaria control programmes CONTROL PRIORITIES >>>>>> Health ministry decision makers POLICY PRIORITIES >>>>>> Malaria researchers RESPONSIVE RESEARCH >>>>>> Malaria control programmes
Some current models of scientific publication relevant to malaria Reader subscription Nature, Science, Lancet, NEJM Learned Society Journal Transactions Royal Soc. Trop. Med. Hyg. Am. J. Trop. Med. Hyg. BMJ Open Access, Govt pays Emerging Infection Diseases (U.S CDC) Bulletin of the WHO Open Access, Contributor pays Malaria Journal, PLoS stable
Malaria publications – Lancet 1990 – 1996 95. Systematic review of amodiaquine treatment in uncomplicated malaria. P Olliaro, C Nevill, J LeBras, P Ringwald, P Mussano, P Garner, P Brasseur. The Lancet - Vol. 348, Issue 9036, 2 November 72. Relation between severe malaria morbidity in children and level of Plasmodium falciparum transmission in Africa. Robert W Snow, Judy A Omumbo, Brett Lowe, Catherine S Molyneux, Jacktone-O Obiero , Ayo Palmer , Martin W Weber, Margaret Pinder, Bernard Nahlen, Charles Obonyo , Chris Newbold, Sunetra Gupta, Kevin Marsh. The Lancet - Vol. 349, Issue 9066, 7 June 1997, Pages 1650-1654. 61. Little to celebrate on the malaria centenary. Sanjay Kumar. The Lancet - Vol. 350, Issue 9078, 30 August 1997, Page 644. 56. Randomised placebo-controlled trial of iron supplementation and malaria chemoprophylaxis for prevention of severe anaemia and malaria in Tanzanian infants. Clara Menendez, Elizeus Kahigwa , Rosmarie Hirt, Penelope Vounatsou, John J Aponte, Fidel Font, Camilo J Acosta, David M Schellenberg, Claudia M Galindo, John Kimario, Honorathy Urassa , Bernard Brabin, Tom A Smith, Andrew Y Kitua , Marcel Tanner, Pedro L Alonso. The Lancet - Vol. 350, Issue 9081, 20 September 1997, Pages 844-850 55. Malaria catastrophe in East Africa. Anders Carlstedt. The Lancet - Vol. 350, Issue 9085, 18 October 1997, Page 1180 43. Molecular assays for surveillance of antifolate-resistant malaria . James G Kublin, Richard S Witzig, Anuraj H Shankar, Jorge Quintana Zurita, Robert H Gilman, Javier Aramburu Guarda, Joseph F Cortese, Christopher V Plowe. The Lancet - Vol. 351, 1998, 1629-1630. 37. Malaria disaster in Africa. Kevin Marsh. The Lancet - Vol. 352, Issue 9132, 19 September 1998, Page 924. 35. Inducible nitric oxide synthase polymorphism and fatal cerebral malaria. David Burgner, Weiming Xu, Kirk Rockett, Michael Gravenor, Ian G Charles, Adrian V Hill, Dominic Kwiatkowski. The Lancet - Vol. 352, Issue 9135, 10 October 1998, Pages 1193-1194 25. Intermittent sulphadoxine-pyrimethamine to prevent severe anaemia secondary to malaria in pregnancy: a randomised placebo-controlled trial . CE Shulman, EK Dorman, F Cutts, K Kawuondo , JN Bulmer, N Peshu, K Marsh. The Lancet - Vol. 353, 1999, Pages 632-636. 24. Malaria on Merseyside David Sharp. The Lancet - Vol. 353, 1999, Page 1452 . 19. Averting a malaria disaster . NJ White, F Nosten, S Looareesuwan, WM Watkins, K Marsh, RW Snow, G Kokwaro, J Ouma , TT Hien, ME Molyneux, TE Taylor, CI Newbold, TK Ruebush, M Danis, BM Greenwood, RM Anderson, P Olliaro. The Lancet - Vol. 353, 1999, 1965-1967 1. Efficacy of artesunate plus pyrimethamine-sulphadoxine for uncomplicated malaria in Gambian children: a double-blind, randomised, controlled trial. Lorenz von Seidlein, Paul Milligan, Margaret Pinder, Kalifa Bojang, Chukwudi Anyalebechi , Roland Gosling, Rosalind Coleman, Justin Ifeanyichukwu Ude, Abubakar Sadiq , Manoj Duraisingh, David Warhurst, Ali Alloueche, Geoffrey Targett, Keith McAdam, Brian Greenwood, Gijs Walraven, Piero Olliaro, Tom Doherty. The Lancet - Vol. 355, 2000, 352-357.
Publications – Malaria Journal 2007-8 <ul><li>Var2CSA DBL6-epsilon domain expressed in HEK293 induces limited cross-reactive and blocking antibodies to CSA binding parasites Pablo Fernandez, Nicola K Viebig, Sebastien Dechavanne, Catherine Lepolard, Jurg Gysin, Artur Scherf, Benoit Gamain Malaria Journal 2008, 7:170. </li></ul><ul><li>Plasmodium falciparum gametocyte sex ratios in children with acute, symptomatic, uncomplicated infections treated with amodiaquine Akintunde Sowunmi, Sulayman T Balogun, Grace O Gbotosho, Christian T Happi Malaria Journal 2008, 7:169. </li></ul><ul><li>Multiple insecticide resistance mechanisms involving metabolic changes and insensitive target sites selected in anopheline vectors of malaria in Sri Lanka M Devika B Perera, Janet Hemingway, SHP Parakrama Karunaratne. Malaria Journal 2008, 7:168. </li></ul><ul><li>Reduced paediatric hospitalizations for malaria and febrile illness patterns following implementation of community-based malaria control programme in rural Rwanda Amy C Sievers, Jennifer Lewey, Placide Musafiri , Molly F Franke, Blaise J Bucyibaruta , Sara N Stulac, Michael L Rich, Corine Karema , Johanna P Daily Malaria Journal 2008, 7:167. </li></ul><ul><li>The economic burden of malaria on the household in south-central Vietnam Chantal M Morel, Ngo Duc Thang, Nguyen Xuan Xa, Le Xuan Hung, Le Khan Thuan, Pham Van Ky, Annette Erhart, Anne J Mills, Umberto D'Alessandro Malaria Journal 2008, 7:166 </li></ul><ul><li>Unforeseen misuses of bed nets in fishing villages along Lake Victoria Noboru Minakawa, Gabriel O Dida, George O Sonye , Kyoko Futami, Satoshi Kaneko Malaria Journal 2008, 7:165. </li></ul><ul><li>Integrated vector management: the Zambian experience Emmanuel Chanda, Fred Masaninga , Michael Coleman, Chadwick Sikaala, Cecilia Katebe , Michael MacDonald, Kumar S Baboo, John Govere, Lucien Manga Malaria Journal 2008, 7:164. </li></ul><ul><li>Insertion polymorphisms of SINE200 retrotransposons within speciation islands of Anopheles gambiae molecular forms Federica Santolamazza, Emiliano Mancini, Frederic Simard, Yumin Qi, Zhijian Tu, Alessandra della Torre Malaria Journal 2008, 7:163. </li></ul><ul><li>Malaria incidence in Limpopo Province, South Africa, 1998-2007 Annette AM Gerritsen, Philip Kruger, Maarten F Schim van der Loeff, Martin P Grobusch Malaria Journal 2008, 7:162. </li></ul><ul><li>The M18 aspartyl aminopeptidase of Plasmodium falciparum binds to human erythrocyte spectrin in vitro Sonja B Lauterbach, Theresa L Coetzer Malaria Journal 2008, 7:161. </li></ul><ul><li>Improving community health worker use of malaria rapid diagnostic tests in Zambia: package instructions, job aid and job aid-plus-training Steven A Harvey, Larissa Jennings, Masela Chinyama, Fred Masaninga , Kurt Mulholland, David R Bell Malaria Journal 2008, 7:160. </li></ul><ul><li>Spatial prediction of Plasmodium falciparum prevalence in Somalia Abdisalan M Noor , Archie CA Clements, Peter W Gething, Grainne Moloney, Mohammed Borle , Tanya Shewchuk, Simon I Hay, Robert W Snow Malaria Journal 2008, 7:159. </li></ul><ul><li>Establishment of a large semi-field system for experimental study of African malaria vector ecology and control in Tanzania Heather M Ferguson, Kija R Ng'habi , Thomas Walder, Demetrius Kadungula , Sarah J Moore, Issa Lyimo , Tanya L Russell, Honorathy Urassa, Hassan Mshinda , Gerry F Killeen, Bart GJ Knols Malaria Journal 2008, 7:158. </li></ul>
Summary and conclusions Knowledge is a weapon of great value in the fight against malaria Scientific publishing has a key role in the movement of this knowledge Open Access is enabling a greater participation of African scientists in knowledge exchange These scientists are part of an upsurge in research capacity in Africa These scientists will make crucial contributions in the fight for malaria control
Thanks to: Colleagues in the malaria research community BA Festival of Science BMC & the Malaria Journal Wellcome Trust UK Health Protection Agency