- Acute spiking fevers
- Multi-organ failure

- 3 million people die per year
- 1 African child dies every 30 seconds
- Number of deaths worldwide in 2006 higher than in 1998

- Malaria is treatable & preventable
- In 2000, fifty-three African heads of state pledged to cut deaths from malaria in half by 2010 through the row back malaria campaign
- This project & international alliance of > 90 organizations including the WHO, UNICEF &the World Bank has gone nowhere despite the prominent groups involved

- Malaria is tough opponent
- Human poverty

- Infection caused by the parasite Plasmodium
- Transmitted to humans by the anopheles mosquito, unique carrier and transporter a plasmodium for three reasons
• Multiplies the parasite
• Flies
• Bites humans

- In developed nations → malaria is no longer a problem
• Modern housing with screens → mosquitoes have no access to humans
• Nations with resources
• • Drained swamps to eliminate breeding grounds
• • Use of indoor insecticides
• • Implement focused intervention when public health surveillance reveals early outbreak
- In US:
• 1,500 cases in the past half-century
• > 90% contracted outside US and carried into the country by travelers
• 70% contracted the disease from blood transfusions

- Anopheles mosquito seeks a blood meal for nourishment
- Bites a human and injects the parasite into his bloodstream
- Parasite travels rapidly with the blood throughout the body & centers in liver cells which seem to be extraordinarily hospitable
- In the liver, a single parasite can multiply into as many as 40,000 daughter cells within days
- When the membranes of the cells can hold no more, they burst → release the load back into the bloodstream
- These cells then enter red blood cells, multiply another 24 times or so and burst again
- Within two weeks, the human will feel the effects with fever and chills every 48 to 72 hours timed with the red blood cell bursts
- Anemia often develops with further red cell destruction
- Death comes as a result of extensive organ failure
- While in the red blood cells, the Plasmodium parasite develops into male and female reproductive forms
- When the infected victim is bitten by a new mosquito, these forms of the parasite go into that mosquito
- They mix inside the insect’s stomach, multiply and eventually burst
- Thousands of cells travel to the mosquitoe’s salivary glands → become poisoned and ready to enter & infect the next human who comes along

- Malaria is a disease of poverty, helped along by it and actually contributing to it
- Plasmodium parasite is a uniquely complex enemy
• has more than 5,000 separate proteins
• nearly invisible to our immune system
• → we have difficulty mounting a response to its entry into our bodies because we barely recognize its presence
• numbers of proteins & immune system sensitivity come into play when you're trying to develop an effective vaccine

- 60% of the 100 or so vaccines under development for malaria target just four of the 5,300 proteins
- Are they the right ones to generate human immunity?

- Traditional low-cost medicines for malaria are increasingly ineffective
- Drugs like chloroquine, quinine & sulfadoxine- pyrimethamine have been sidestepped by Plasmodium whose modern variants have developed resistance to these therapies
- New brand of medicine, artemisinin compounds, used in combination with older compounds which can cure malaria in as few as 3 days
• if you can get to a doctor or a clinic
• if the diagnosis is made
• if the medicines are there and available to you despite your lack of resource
• if you take them as directed
- Back to question of poverty!

- The poorest of the poor mainly in sub-saharan Africa are caught in a poverty trap that's exacerbated by rapid increases in population
- High childhood mortality rates that go along with malaria infestation → reactive high fertility rates
- Already compromised adults have more children than they would normally, to achieve the desired number of surviving children
- High fertility–high mortality environment presents very high costs at both a household and a national level
• even the children who survived have poor nutrition and are often cognitively impaired
• → mothers are tied up with the sick children
• → crops don't get planted
• → nutrition declines
• → savings and investment income falls
• → children miss school
• → parents are less able to migrate toward where the work and the clinics are available

- Widespread availability of artemisinin combination therapy at low cost with timely intervention; it's possible through organized efforts to get this medicine to the poorest of the poor
- Massive distribution of free insecticide treated bed nets with training throughout endemic areas and consistent use reinforced by public companies,
- Reinstitution of the use of DDT indoor sprain twice a year, the phasing out of DDT as part of the persistent organic pollutants treaty in the late 1990s has now been clearly linked to advancing spread of the disease in the past decade

- Key to breaking poverty trap is increasing assistance from rich countries to enable the poorest countries to put the basic infrastructure in human capital in place, this will help fight disease, establish a network of primary healthcare posts, improve and extend schooling & build the network of roads, power & telecommunications on which a modern economy depends
- Malaria may not be a concern in the West but ignoring its impact on a world we are increasingly connected to is a mistake of historic proportions

Demo Content