04 April 2003
Malaria Still The Biggest Killer in Africa, Researchers Told
(British Doctor weighs contributing factors versus prevention needs)
(810)
By Jessica Allen
Washington File Staff Writer
Washington -- Every thirty seconds, malaria claims another victim in
Africa. And this year, 750,000 of those victims will be children under
the age of five, according to Dr. Brian Greenwood, director of the
Malaria Centre at the London School of Hygiene and Tropical Medicine
and a leader in malaria research for three decades.
Speaking at an April 2 National Institutes of Health (NIH) conference
on the importance of preventative medicine in the fight against
malaria on the African continent, Dr. Greenwood added that although
the burden of malaria weighs heavily heavy on the continent, all is
not lost.
Greenwood, who is also the Director of the Gates Malaria Partnership,
an initiative to combat malaria funded by Microsoft founder Bill Gates
and his wife Melinda, lamented the fact that after malaria was nearly
eliminated in Europe and North America the quest to develop new drugs
was pretty much abandoned by most of the medical community.
Despite that, Greenwood said, the search continues at research
institutions like his own and the NIH for new control tools to battle
the mosquito-borne parasite that causes malaria. At the same time,
international donors are developing new funding mechanisms that could
make those tools available to poor countries.
He explained pregnant women given sulphadoxine or pyrimethamine during
their second and third trimesters were protected from malarial anemia
and had higher than average infant birth weights. Women with HIV/AIDS
had varying results. He also reported that researchers had discovered
that infants given Fansidar in conjunction with their vaccinations had
markedly fewer occurrences of malaria and anemia.
Malaria is not localized to Africa, Greenwood said, but its effects
are felt there most strongly. Malaria afflicts 500 million people
around the world and one million people die from the disease every
year. But 90 percent of all malaria-caused deaths occur in Africa. The
question is why malaria poses so great a threat to there relative to
the rest of the world.
According to Greenwood, malaria continues to be prevalent and virulent
on the African continent for a number of reasons. One of the main
reasons is that drug-resistant malarial strains have spread throughout
the continent.
The drug Chloroquine, a traditional treatment, is now having little,
if any, effect in Africa and increasing numbers of malarial strains
are showing resistance to similar medications like sulphadoxine or
pyrimethamine, he explained.
In addition, mosquitoes that carry the Plasmodium parasite have become
resistant to the insecticides now in use, thus escalating the spread
of the disease, Greenwood said. Mosquitoes present in West and South
Africa have demonstrated great resistance to pyrethrum-based
insecticides, one of the main types of insecticide used in Africa.
This new resistance to pyrethrins is a threat to the effectiveness of
insecticide-treated bednet programs that require curtains and netting
placed around beds to be treated with insect repellant. Since many
bednets are treated with pyrethrins this method of protection has been
rendered less effective.
Ultimately, money and people are the answer, Greenwood said. If more
people were engaged in anti-malarial and insecticide research and more
money and support were thrown into the search for new anti-malarials,
help could get to Africans more quickly, he said. Without more
research and funding, Africans will be left helpless in the face of
the ineffectiveness of the anti-malarial drugs and insecticides now in
use.
Wars and civil disturbances have also contributed to the spread of the
disease, the doctor said, with refugee populations becoming carriers
and victims when they are unable to receive timely treatment due to
lack of medicines and the destruction of medical facilities.
Greenwood noted environmental and climate changes have also had a
negative effect on the effort to rid Africa of malaria. While floods
resulting from global warming can hasten the spread of the disease,
manmade constructions such as dams in Ethiopia do far more damage by
creating the warm aquatic environments mosquitoes need to lay their
eggs.
Population growth and migration are also factors, according to
Greenwood. The population growth rate in Africa is high, and there is
an increased movement of uninfected Africans traveling through
high-risk malarial areas, both of which put more people in danger of
contracting the disease with little hope of receiving adequate and
timely treatment, due to the limited funds available.
The World Health Organization (WHO) estimates that the cumulative
effect of malaria over the past three decades results in a cost to
African countries of over $100,000 million a year in lost output. In
contrast, Greenwood said, the cost of making and disseminating
anti-malarials is very cheap. If more anti-malarials were created and
distributed, African medical expenses would be greatly reduced and
governments could move one step closer to financial independence.
(The Washington File is a product of the Office of International
Information Programs, U.S. Department of State. Web site:
http://usinfo.state.gov)
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