Rolling back malaria

The symptoms of acute malaria are sudden feverish feeling, loss of appetite, chills, sweats and rigour (shivering) and gbp (general body pains), plus or minus headache. Those of severe malaria include all these, and then some — like severe weakness or dizziness, paleness or anaemia, abdominal pain, joint pains and eye ache (which patients sometimes think is migraine) plus or minus unconsciousness, plus or minus malaria nephropathy (kidney impairment). When the concentration of malaria parasites is close to 33 per cent in the blood, it is said to be scanty; when it is up to 66 per cent, it is few; but when it is above that, it is many, and at this point, the patient is in extreme danger. A young medical doctor friend adds that there is a high occurrence of the ‘many’ condition in rural areas, where mosquito breeds more easily. He laments that close to 70 per cent of maladies brought to his rural public hospital are linked to mosquito bites.

In a study titled, ‘The Economic Burden of Malaria,’ by John Luke Gallup and legendary Jeffrey D. Sachs, in rural Garki, Abuja in Nigeria of the 1960s, the intensity of malaria transmission was “Very high indeed. During the wet season, a person… would be bitten on average 174 times per night by the Anopheles gambiae malaria vector and 94 times per night by the Anopheles funestus vector.” It is truly more dangerous to live in  rural areas than in urban areas. Because, even in these modern times, intensive malaria occurrence is largely confined to the tropical and subtropical zones. There should be little wonder that Africa was once referred to as ‘The White Man’s Grave.’ Pre-colonial Africa was the death of several European missionaries, explorers and fortune seekers.

The mosquitoes that carry the Plasmodium parasite get it from biting a person or animal that is already infected. Malaria can also be transmitted from mother-to-child during pregnancy. So you can get malaria if you’re bitten by an infected mosquito, or if you receive infected blood from someone with malaria parasite. When it gets into the bloodstream of a victim, the parasite invades the red blood cells, and propagates into an extremely large number. When the infected red blood cells burst, it sends the parasites throughout the entire body and causes symptoms of malaria that overwhelms the human body. Apart from the sickness and death that it causes, malaria also affects the economy of nations.

Plasmodium falciparium, is more deadly than Plasmodium vivax, Plasmodium malariae, and Plasmodium ovale. The anopheles mosquito is the main carrier of Plasmodium falciparium, which causes the death of hundreds of thousands of people annually, mostly children below age five. Some species of mosquito carry the filariasis worm, a parasite that causes elephantiasis, a swelling which usually disfigures parts of the body. The viral diseases — yellow fever, dengue fever and the strangely named ‘chikunguya’ — are transmitted by the aedes aegypti species of mosquitoes. Since 1946, Japan and OECD nations have been able to roll back the impact of mosquito. The Mediterranean region has also escaped the scourge. But malaria still remains mostly in Africa, South America, Central America, and Asia. The plasmodium parasite, which constantly adapts to its surroundings, has proved to be largely resistant in these regions.

Now, here is good news. A report says researchers from the American National Institutes of Health, Navy, Army and other organisations, have made a significant breakthrough in the fight against malaria with a new vaccine. PfSPZ has delivered an astonishing 100 per cent effectiveness against malaria. It is made from weakened sporozoites of malaria parasite Plasmodium falciparum: Indeed, the ‘p’ and ‘f’ alphabets indicate ‘plasmodium falciparium.’ PfSPZ, which sort-of arrests the disease, is currently available only by intravenous (IV) injection. Stephen Hoffman, the CEO of the biotech company that developed the vaccine, says, “We have demonstrated… that one can completely protect individuals against malaria- infected mosquitoes.” It is important to note that the success of PfSPZ is still at the experimental stage. If further studies, planned for Tanzania and other parts of Africa, confirm its efficacy, PfSPZ vaccine should hit the market by 2017 — just four years away.

Considering the centuries that malaria has ravaged the world, four years is not a long wait.

Despite breakthroughs in genetics, parasitology, entomology, drug development, and other areas, man’s battle against malaria has not been too successful. The battle has been on three major fronts: Attempts to simply kill off the mosquito carriers with disinfectants; quarantine or isolating infected people from mosquitoes, so that others do not get infected; and applying the preventive vaccine. In addition, man has developed a natural resistance or immunity to the disease. Over the centuries, the sickle cell, found, not only in people of African descent, but also in Asians and Arabs, was developed by the body to resist malaria. The name, sickle cell, is derived from the ‘s’ shaped farm implement, the ‘sickle,’ because the red blood cell of victims typically assumes an ‘s’ shape. The sickle cell, which leads to the sickle cell anaemia, is an inherited blood disorder, which somewhat protects its victim from malaria. But this comes at a devastating cost: A victim of the sickle cell anaemia cell often descends into wracking body pains and tiredness, and has difficulties living life to the fullest. People tend to think that the victims are lazy.

The Malaria Foundation International was established to address issue of the economic importance of malaria.  The foundation’s mission “Is to facilitate the development and implementation of solutions to the health, economic, and social problems caused by malaria.” The Gallup and Sachs study suggests that malaria and poverty are intimately connected: That if you disregard factors like tropical location, colonial history, and geographical isolation, countries with intensive malaria had income levels in 1995 of only 33% of that of countries without malaria. Also, countries that have been able to eliminate malaria record substantially higher growth — within a mere period of five years. The study adds: “Not only are malarial countries poor, but economic growth in malarial countries over the past quarter century has been dismal. Growth of income per capita 1965–1990 for countries with severe malaria has been 0.4% per year, whereas average growth for other countries has been 2.3%, (about) five times higher.”

Though largely speculative, Gallup and Sachs conclude that the illness of malaria has lifelong effects on education. The cognitive development and education levels of kids are impaired through loss or waste of time as a result of chronic malaria-induced anaemia. They add that malaria negatively impacts on an economy in the following ways: Potential foreign investors may take their investments elsewhere because they simply want to avoid malaria. As the educated segment of the population of a nation with the malaria scourge prefer to live in malaria-free urban centres, they take away their competence for positive social and economic change to the urban centres. If this wonder drug really works, it will greatly relieve the black man’s burden of illness, result in a healthier workforce, and decrease absenteeism at work. This should give the Nigerian ministries of health, economic development and planning the incentive to renew the impetus that the Roll-Back Malaria campaign lost in recent times.

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