The Challenge of Malaria

The Institute of Medicine of the US National Academy of Sciences points out that malaria a major disease in developing countries is expected to become even worse in the future due in part to the plasmodia becoming more and more resistant to chloroquine and the vectors becoming more and more resistant to insecticides. Further the Hardy-Weinberg equation uses heterozygous gene frequency mutations in the beta chain of hemoglobin A resulting in hemoglobin S in Africa or in the erythrocyte membrane protein band 3 in Southeast Asia to predict that mortality from malaria is likely to increase. A researcher from the US National Institutes of Health believes the best research tools to control malaria are those that focus on Plasmodium falciparum and Anopheles mosquitoes rather than just short term benefits of insecticides. The 1st priority should be continued research on an effective vaccine against the asexual erythrocytic plasmodia has much potential since it is this stage that causes disease. Even if it is only able to induce partial immunity the parasite load will be reduced thus reducing mortality. Further a vaccine that would interfere with transmission at the sporozoite or sexual stages used in combination with other forms of control could eliminate malaria in areas of moderate transmission. Another route would be focusing research efforts on those factors that either destroy or block plasmodia in the mosquito or to introduce genes for these factors into the mosquito population. Moreover identifying biochemical pathways unique to plasmodia and development of poisons specific to them presents a promising possibility. For example research can focus on understanding the structure and function of the polymerase and efflux mechanism where plasmodia transform hemoglobin into a nonpoisonous compound. Industry should join with basic scientist to limit and/or prevent malaria.