Malaria: The Preventable Killer, Research Paper Example

There are no current vaccines or legally acceptable chemicals to prevent and eradicate the Malaria disease, 90% of which is killing Sub-Saharan Africa children at the rate of 1 million annually, after being bitten by the anopheles mosquitoes which can easily be controlled by the use of nets and insect repellants, yet the epidemic rages on with the support of governments, profit seeking pharmaceutical companies, vested environmental interests and the even European Union.

However, with appropriate leadership and vision, the battle can be won on the basis of strategies that entail the use the most effective treatment program, and the confronting relevant variables like Western perceptions, economics, financial gains, scientific misunderstanding and manipulations, poverty, deliberate deprivations of resources and politics, all at the same time.

Introduction

The disease Malaria, which directly affects humans by the infection of the protozoan virus belonging to the genus Plasmodium, is characterized by chills, fever, followed by coma at the severe stage followed by death. Transmission of the disease comes via the bite of the Anopheles Mosquito which is the vector of the plasmodium falciparum strain of the protozoan virus, takes place in over 100 countries of the world as such makes it a global disease generating as much as 450 million cases annually in Sub-Sahara Africa alone, according to Appiah-Darkwah and Kofi Badu-Nyarko (2011).

The prevalence of the disease and subsequent lack of more widespread intervention programs may be due to what activist call the 10/90 Gap, which according to Drugs for Neglected Disease Working Group (2001), is the position in the industry where 10% of the global health research is devoted to 90% of the global disease burden.

Malaria is among the category of diseases that are neglected by the Research and Development arm of Pharmaceutical Drug companies, because of its prevalence in low income countries, according to Stevens (2004), and it could be argued that if these companies invest their resources and produce drugs for treating the disease in these countries, they would lose their investments, as these countries would not be able to pay for the products.

Hays (2005), reports that malaria is numbered among the great contemporary infectious epidemic killers along with AIDS, tuberculosis, and although requiring very inexpensive treatment, the disease has remain unaffordable to low income families and serious strain on the budgets of respective government. The problem goes even further according to Hays (2005), in that the presence of the disease depresses tourism and drives away Foreign Direct Investment of multilateral and other agencies, once the World Health Organization issues travel advisory warnings.

The attitude of Western Nations contribute significantly to the malarial epidemic in low economy regions of the world, cites Hays (2005), principally because tuberculosis and malaria has been successfully eradicated form these countries and they believe that these diseases of the past, are not longer a threat anywhere, and hence they will ignore news that are contrary to their beliefs.

Shaw (2010) adds that after the ignominious failure of the 1950’s era DDT assault on malaria, the disease disappeared from the lecture theatres, school rooms, and the bookshelves, as well as from the Research and Development budgets of pharmaceutical companies, causing the world to believe that the disease was no longer a threat. This no doubt constitutes a major reason why malaria has become the preventable killer disease in the 21^st century.

Body

The Disease Malaria has been described as a chronic weakening disease which affects an individual’s ability to work, so that in the final analysis it can cripple communities, workplaces, the education process, and eventually an entire nation, especially in terms of productivity, family support, and the supply of goods and services to maintain an economy.

According to Hays (2005), the causative agent responsible for Malaria is the Plasmodia Virus, which exist in three main strains, namely plasmodium falciparum, plasmodium vivax, and plasmodium malaria, with the first and second strain being the most serious and the least effective respectively.

 Treatment The objective of every treatment program should be vector eradication, which means the destruction of the anopheles mosquitoes from its breeding ground and from other areas of the environment, which Hays (2005) asserts can be done through spraying the affected areas with insecticides and managing waters resources, which include swamps, stagnant and supplies everywhere. Additionally, the use of window screens devices and nets will also serve as effective defense against the vector

Chloroquine was an effective drug used to treat the disease prior to the 1980’s, according to Hays (2005), but as mosquitoes, through the plasmodium falciparum strain developed resistance, it gave way to the application of the drugs like Pyrimethamine, Sulfa, and Mefloquine, but these all carry increasing costs as much as ten-fold in some cases, and this severely limit the capacity of several African countries to develop comprehensive treatment programs for the affected populations.

However, since the cessation of the use of DDT, the adaptability of the Plasmodium falciparum strain of the malaria parasite to all current drugs on the market, has presented the strongest challenge to the researchers in the medical field that are in the pursuit of an effective remedy for treating the disease.

Critical to the successful treatment of malaria it is believed, is its early recognition and treatment in children, but poverty, a lack of available medical facilities, as well as the under-funding of research programs to find cures, has in part made short and medium term success very limited.

The 1990 Manuel Patarryo Malarial Trial A vaccine was developed in the middle of the 1990’s by Columbian Manuel Patarryo using a chemical synthesis of three peptides with malarial based parasitic fourth, and clinically tested against the Plasmodium falciparum strains in Columbia, Ecuador, Venezuela, and Tanzania among population samples of 600 children respectively, achieved a success rate of 31% overall.

The project however, did not elicit further financial support, perhaps because of the results obtained, but critics has argue that 31 % was a start, and with proper financing and other material support from the WHO and UNICEF, millions more lives could have been saved, especially in Africa, where over 3000 children are dying on a daily basis from the parasite.

The NMCP and Nougouchi Memorial Institute Projects These two bodies teamed up in 1998 to conduct a research to determine the effect of chloroquin on the plasmodium parasite that caused malaria. The result according to Appiah-Darkwah and Kofi Badu-Nyarko (2011), revealed that the drug no longer had any effect on the malaria parasite, but critics knowledgeable about the program countered by saying that the outcome was due to negative beliefs about the disease, a lack of adequate knowledge about the disease, poor attitude towards dosage and bad prevention and control measures.

A lack of progress in the search for a vaccine or chemical related products, has perhaps led Tina Rosenbery to echo a call for the return of DDT to the chemical market. According to Berry (2004), Tina Rosenbery in her article “What the World Need Now is DDT”, called for the re-introduction of the powerful mosquito insecticide name dichloro diphenyltrichloroethane, which was used to fight the tropical diseases and poverty in the first World, before it was banned globally.

The ban asserts assert Berry (2004) came about as a result of Rachel Carson’s 1962 best seller Silent Springs, which highlighted destructiveness of spraying DDT on the environment by providing pictures of birds, salmon, and other wildlife, but not the millions of lives that the application of the spray had saved from the horrible emaciated death caused by malaria and yellow fever.

What Rosenbery was advocating according to Berry (2004), was a reversal of a great scientific deception and subjective application of information which has allowed millions of people to die unnecessarily. The argument has merit, in that with the level of knowledge that is available today, in terms of environment management and sustainability, DDT could be easily controlled while being used to eradicate malaria.

In support of his argument, Berry (2004) went further to inform that tests have shown that when DDT was applied in miniscule concentrations levels in military settings and in residential locations as mosquito repellants, enormous success was obtained with negligibly environmental damage.

The benefit that the African continent in particular could have had from the use of the DDT program could have been phenomenal , but the shortsighted EPA overlook such an option, and instead ban the product, so that when the patent ran out production became very expensive and combined with its low popularity, not many companies found he option attractive..

Little did Rachel Carson knew that although she might had made million from her bestselling book, her subjective and unscientific approach influenced even the highly scientific persons in the country as well as help to prevent millions of African babies and adults from living and making positive contributions to their respective nations.

Historical Review The disease Malaria, according to Desowitz (1991), have been affecting human beings as far back as millions of years ago when Homo erectus travelled from Africa to Asia, and history reports that the early Sumerians and Chinese described fevers that were typical of the preventable killer society still face today.

Desowitz (1991).speculatively gave an indication as to journey that malaria have taken through time and its impact, when he inserts that European settlers and the slaves they imported, contributed to the presence of malaria and caused it to remain the American disease until the 1940’s. The disease has fought and won battles against Quinine, Chloroquine, the Chinese herb Qinhaoso and DDT-through contracted use, due to the ability of the parasite to develop highly resistant strains, according to Desowitz (1991), and this no doubt attributed to the continued presence of the disease that is presently affecting upwards of 200 million persons today.

The Stockholm Convention on Persistent Organo Pollutants (February 1997) The Stockholm Convention on persistent Organo pollutants adopted a strategy that the US EPA should have embraced regarding the use of DDT, rather than imposing a national ban on the product. The august body, according to N’Guessan et al. (2010), stipulated that due to the damaging impact of DDT on the environment, countries should be encouraged to reduce and eliminate the use of the product overtime, and switch to alternate insecticides like organophosphates, carbamates, and pyrethroids.

These chemicals however, were more expensive, had short shelf life, and may not be ideally to fight malaria at the outset due to a lack of proper research methodology and efficacy according to N’Guessan et al. (2010). In this interim period while research was underway, countries should have be able to use DDT, under more stringent environmental management programs, but because of the ban, malaria infection was allowed to increase globally in poor countries, causing tremendous loss of lives, and disruption of economies.

The Malaria Genome Sequencing and Analysis This current research led by Professor Dan Neafsy of Harvard School of Public Health offers some hope to the world in terms of finding a cure for the preventable disease killer. The research focuses on the population genome of the malaria parasite and the Anopheline mosquitoes, with the intention of planning and executing genome sequencing and high throughput genotype projects that relates to malaria, according to Harvard School of Public Health (2012).

Critical work by Professor Neafsy and his team also involve using analyses and tools from the fields of population genetics and molecular evolution to investigate questions regarding the natural selection of in plasmodium and Anopheles genomes, the structure of the parasite and vector populations, and the mechanisms by which resistance to drugs and insecticide evolves in parasite and vectors, according to the Harvard School of Public Health (2012).

This project is heading in the right direction and success in it would be a defining moment in the history of the world and the fight against malaria, as it would bring about the salvation of millions of people who are suffering from the disease in at least 100 countries in the world presently.

Efforts to Control Malaria in Africa The global Fund and the President’s Malaria Initiative provided support to International efforts to control malaria in many parts of Africa using strategies based on long lasting internal nets (LLIN) and residual indoor spraying, according to Bhattaran et al. 2007) as part of the Roll Back Malaria program.

In Zanzibar in particular artemisinin based combination therapy for uncomplicated malaria was applied in 2003 free of cost to all malaria patients, while the LLIN program entail free treatment to all children under 5 years old in 2006, according to Bhattaran et al (2007).

The results of the impact of these programs on the trends and prevalence of Plasmodium falciparum showed that mortality rates for children under 5 years old, infants below the age of 1, and children between 1 and 4 years old had decreased by 52% 33% and 71 % respectively, according to Bhattaran et al. (2007)

Replication of this program in other parts of Africa and the world would provide substantial evidence that the disease with the appropriate amount of support can be cured over time, and the millions of lives that are being lost can be avoided

A Cost Effective Drug The most cost effective drugs and long lasting residual insecticide to have controlled malaria according to N’Guessan et al. (2010), was DDT, which was also found to be environmentally persistent.

However, Dow Agro-Science has recently developed a microencapsulated organophosphate name chlorpyrifos methyl as a long lasting cost effective substitute to DDT. The product was tested in an area of Benin in Africa where the Anopheles gambiae and Cutex quinquafasiactus parasites were known to be resistant to pyrethroids, but susceptible to organophosphates.

The results were compared to those of DDT and pyrethroid lambdacyalothrin, and proved to be superior in performance in that it achieved a 95 % kill compared to 31 %v and 53 %v respectively for the pyrethroid and DDT respectively.

In the final analysis N’Guessan et al. (2010) concluded that base on the remarkable results obtained, a cost effective alternate product to DDT has finally been found through the use of a feasible modern formulation technology.

Conclusions

The reasons Malaria has remained the preventable killer disease are therefore many, and all these variables will have to be confronted simultaneously to reverse the trend. Countries with weak economies are unable to provide the resources to sustain their economies as well as provide the remedies to fight this chronic disease that kills approximately 1million children annually.

When malaria is found to be present in epidemic proportion in any country, it will also deprived of the benefits that would accrue from tourism and Foreign Direct Investments, in that prospective tourists and investors, on hearing the WHO and other warnings, will turn to other safer environments to pursue their interests, and thus reduce the earning potentials of affected countries and their ability to provide the remedies to reduce the impact of the disease on their respective populations.

The effect of the disease also exacerbate the conditions in poor countries, in that it weakens individual, reduce their strength to work and in the short term and medium affects the productivity of poor economies through low employment, as well as excessively high mortality rates at the same time.

Malaria eradication, for economic, political and psychological reasons, are not a viable options for pharmaceutical companies, governments and other stakeholders, especially after the cessation of DDT use through the graphic environmental disaster shown by Rachel Carson in her Silent Spring Book, the EPA ban on the product, and the fact that the disease affects mainly poor people who will not have the purchasing power to ensure public owned companies profits from the revenues that will be generated.

Additionally, the disease unlike the HIV AIDS virus has been perceived as belonging in the past because it has been totally eradicated from the environment of the Western and European countries, and many of these governments have little or no interest in providing the assistance needed.

Research work on malaria by the NMCP and the Nougouchi Memorial Institute using chloroquin to find a cure for the disease may have produced negative results, but the prospects of the research now being conducted by Professor Dan Neafsy and his team of scientists at the Harvard School of Public Health, on the population genome of malaria parasite to execute genome sequencing and high throughput genotype projects that relate to malaria, as well as the success of the control programs in Zanzibar and the clinical efficacy obtained, using chlorpyrifos methyl synthesized by Dow Afro-Science, has provided strong evidence that malaria will be conquered in the medium to long run and millions of deaths will eventually be prevented.

Works Cited

Appiah-Darkwah, I., and Kofi Badu-Nyarko, S. “Knowledge of Malaria Prevention and Control in a Sub-Urban Community in Accra, Ghana” International Journal of Tropical Medicine (2011) Vol. 6 Issue 3 pp.61- 68

Bhattarai A, Ali SS, Kachur SP, Martesson A, Abbas AK, Khatib R, Al-Mafazy AW, Ramsan M, Rotllant G, Gerstenmaier JF, Molteni F, Adulla S, Montgomery SM, Kaneko A, Bjorkman A: “Impact of artemisinin-based combination therapy and insecticide-treated nets on malaria burden in Zanzibar”. PLoS Medicine 2007, Vol. 4:p. 309

Desowitz, Robert, S. “The Malaria Capers More Tales of Parasites and People Research and Reality”, Norton, New York NY. (1991) Print.

Drugs for Neglected Working Groups. “Fatal Imbalance” The Crisis Research and Development for Drugs and Neglected Disease MSF (2011) Print.

N` Guessan, Raphael, Boko, Pelagie, Odjo, Abibathou, Chabi, Joesph, Akobeto, Martin & Rowland, Mark. “Control of pyrethroid and DDT-resistant Anopheles gambiae by application of indoor residual spraying or mosquito nets treated with a long-lasting organophosphate insecticide, chlorpyrifos-methyl”, Malaria Journal (2010) Vol.9 Issue 44 Print

Hays, Jo, N. “Epidemics and Pandemics: Their Impact on Human History” ABC-CLIO Santa Barbara, CA 2005, pp.458-483 Print.

Harvard School of Public Health, “Harvard Malaria Initiative Science of Eradication: Malaria” (2012) Retrieved from: <www.hsph.edu/research/hmi/science-of-eradication-malaria/science-of-eradication-faculty-index.html> 04/29/12 Electronic.

Rosenberg, Tina. “What the World Need Now is DDT” Time Magazine New York April 2004. pp. 38- 43. Print.

Shaw, Sonia. ”The Fever: How Malaria Has Ruled Humankind For 500,000 Years” Sarah Crichton Books New York NY 2010. Print.

Stevens, Phillip. “Disease of Poverty and the 10/90/ Gap “International Policy Network Hanway Print Center, Islington NI 2004. Print.