A big boost to the global fight against malaria

It goes without saying that the Bill & Melinda Gates Foundation's donation totaling $258.3 million to the global fight against malaria is being lauded the world over, especially in developing countries in Africa and Asia. However, nobody can feel more relieved than those who have actually experienced the primary manifestations of the disease: high fever that often shoots up on alternate days and brings on chills that even three blankets fail to quell—yet often goes undetected in blood samples tested for the malarial parasite.

The use of insecticides like DDT to curb the breeding of mosquitoes in still water and puddles that collect after the monsoon season of the Indian sub-continent has been stepped up, but the incidence of malaria and the pediatric deaths it causes are still high enough to cause worry.

Government and collective community action is often a case of too little done too late. In African nations too, especially those in the sub-Saharan belt, where mosquitoes thrive all round the year, there is an acute lack of protective nets and counter-offensive measures. The high temperature sees children wear scanty attire exposing their delicate limbs to mosquito bites.

Perhaps because this disease afflicts poorer countries, malaria has received little attention from the major global recipients of research and development funds. The layperson in the Western world is largely ignorant of the ramifications of this killer disease. In fact, many overseas travelers to developing countries first hear of malaria when they are asked to take anti-malaria tablets that merely postpone the onset of the disease till their return, if indeed they are bitten.

Hence, this five-year long-term donation and the joint ventures that have been established as a result of it between PATH Malaria Vaccine Initiative, GlaxoSmithKline Biologicals and African investigators to clinically evaluate and further refine the prototype (currently under trial) anti-malarial vaccine RTS,S., the Innovative Vector Control Consortium to develop ways to prevent the spread of the disease by effective mosquito control and the Medicines for Malaria Venture to step up the development of successful, yet safe and cheap drugs to treat malaria are more than enough reason for cheer. Interestingly, GSK Bio performed the early development work on the proposed vaccine in collaboration with the US government's Walter Reed Army Institute of Research.

Close on their heels however, is an initiative by the Indian Council for Medical Research which will see human trials of two more proposed vaccines, one having a peptide base and another being derived from human DNA, commencing in 2007. The health ministry is confident that the trials will be successfully completed and a malaria vaccine will be available by the year 2010. In the past, The International Centre for Genetic Engineering and Biotechnology, with centers in New Delhi (India) and Trieste (Italy), partnered the Malaria Vaccine Initiative at PATH and Bharat Biotech International Limited (India) for extensive research on a malaria vaccine.

While the malaria parasite was discovered 125 years ago by Charles Louis Alphonse Laveran, numerous efforts to develop a preventive vaccine against the disease have been underway in various stages of development since the last 50 years. Apparently, the world is now coming close to this vaccine becoming a reality, with both the Gates' supported vaccine endeavor being purported to make it to the global market and African immunization programme by 2011 as well as the Indian offering being made available a year earlier.

What is spurring ahead both the Indian and global efforts is the fact that both in India and Africa, the malarial parasite plasmodium falciparum is becoming resistant to the traditionally administered medicine, chloroquine, commonly known as quinine. In Africa, Dr Chris Hentschel from the Medicines for Malaria Venture said resistance to the commonly used drug chloroquine is as high as 80 percent and that newer artemisinin-based combination drugs are often in short supply and expensive. He further states their research goal as the development of a range of effective drugs that cost $1 or less per person treated.

In addition to these new strains of the parasite, that is transmitted through mosquitoes, health officials have noted that the common insecticides used to control the breeding of mosquitoes are beginning to fail.

Hopefully, all this research will yield a positive preventive measure for what Bill Gates calls a "forgotten epidemic."