WINTER DIALOGUES OF AFRICAN MALARIA COALITION
MIT 26-27 JANUARY 2013
Despite the cold weather, malaria was definitely in the air in Cambridge during the last week in January. Shortly after the African Malaria Coalition held our Winter Dialogues at MIT, Harvard held a Malaria Forum just up the river. There were important differences in the two meetings, but the subject was clearly the same; how to strengthen the fight against malaria.
African Malaria Coalition and the Harvard Malaria Forum
Our two-day Dialogues at MIT explored ways to improve the fight by adding durable methods to the current ephemeral strategy used in Africa, while the Harvard Forum at the Kennedy School discussed ways that business could help (Harvard Gazette). The Harvard Forum on 30 January featured Ray Chambers of the UN, Suzanne McCarron of Exxon-Mobil, Naohiro Takahashi of Sumitomo Chemicals and Dyann Wirth of the School of Public Health, for a 2-hour discussion of the needs and possibilities for support, especially regarding bednets. The forum was also supported by the Harvard Global Health Institute.
The MIT Winter Dialogues of the African Malaria Coalition
The Winter Dialogues at MIT, a continuation of our quarterly dialogues normally held in Manhattan, included (1) a review by the historian James Webb from Colby College of attempts at malaria control in Africa, (2) an insider’s view by Clive Shiff of Johns Hopkins of the current situation in Geneva with the WHO malaria program, and (3) engineering approaches being developed at the Parsons Water Resources Laboratory at MIT by elFatih elTahir and his several graduate students. Participants in the Dialogues included faculty and students from MIT, Boston University, Johns Hopkins, Yale, Colby, and Bentley University. Countries represented besides the US and Canada, were Sudan, Ghana, Nigeria, Zimbabwe and Egypt.
Subjects of Dialogues
James Webb reviewed the history of efforts at malaria control in Africa, leading up to the present efforts by WHO and other international agencies. He noted that most attempts at malaria control had been only temporarily effective, followed by a Malaria Rebound as the control efforts withered due to resistance developing to the drugs and biocides. Thus epidemic malaria occurred among the populations who - in the meantime - had lost their immunity.
Webb says the persistence of international agencies in this kind of blind attack can best be attributed to ignorance, which historians are dedicated to fight. But he also said that it is no longer excusable. Thus a more rational and informed approach is required.
Shiff presented new approaches to epidemiological monitoring being used in Zambia, and suggested that they be used routinely to improve control efforts throughout Africa. Rapid Diagnostic Tests and cell phones have been linked in a system which gives accurate and weekly monitoring of changing geographical patterns of malaria incidence (Kamanga 2010).
The field research presented by Fatih and his MIT group featured computer analyses of malaria transmission in Niger and Ethiopia (Bomblies 2009, Yamana 2010). In addition to simulating transmission and proposed interventions, another objective of this work is to develop ways of building and operating hydropower and irrigation systems in Africa to reduce risks of malaria transmission (Jobin 2011). Koka Reservoir in Ethiopia is being monitored as a first step toward this objective. Presentations were also made on River Blindness and Rift Valley Fever (Jobin 2013).
General discussions of the historical and current programs to control malaria in Africa explored ways to strengthen the technical and institutional problems with the current strategy of drugs, bednets and biocides (Jobin 2012). The ephemeral nature of this chemically-based strategy needs to be strengthened by adding more durable control methods (Jobin 2010).
It was pointed out that the currently under-funded strategy of WHO is again facing the same brick wall of resistance to drugs and biocides which has crippled previous attempts. The gap in global funding for malaria control poses severe challenges.
The presentations also explored more permanent methods - such as better reservoir design and operation for suppression of mosquito breeding - as additions to the current WHO strategy. It was noted that WHO and all global stakeholders should train national epidemiologists and entomologists for permanent positions with local governments, to give a more durable face to the fight.
The Two Malaria Meetings in Cambridge
There were curious differences between the two meetings in Cambridge, especially related to the puzzling numbers used by Ray Chambers regarding the goals and progress of the effort in Africa. He repeated the aspirational goal of zero deaths from malaria by 2015. But this is perhaps part of his promotional orientation, which stressed the decline and shortfall of current funding. However his efforts are also important for our African Malaria Coalition, given the need for additional financial support for all malaria programs (Kiszewski 2007). A note of caution about the recent spread of drug resistance was raised by Wirth at the forum.
In summary, the two meetings in January complemented each other, and indicated the broad nature of the effort to improve the fight against malaria in Africa. These MIT Winter Dialogues of our Coalition were the most successful so far, a very collegial and informative interchange within a remarkably diverse group.
In addition to the references cited below which are available on Amazon.com or PubMed by author citation, I can send you more detailed summaries of the presentations if you are interested.
Bomblies et al 2009, A mechanistic approach for accurate simulation of village scale malaria transmission. Malaria J. Oct 2;8:223.
Harvard Gazette 2013, Science and Health Section, Hitting malaria from all sides, Feb 3.
Jobin 2010, A realistic strategy for fighting malaria in Africa, Blue Nile Monograph One, Boston Harbor Publishers.
Jobin 2011, Health and environmental impact of dams, Blue Nile Monograph Two, Boston Harbor Publishers.
Jobin 2012, Improving the US presidential malaria initiative, Blue Nile Monograph Three, Boston Harbor Publishers.
Jobin 2013, Blood of the lambs, Blue Nile Monograph Four, Boston Harbor Publishers.
Kamanga et al 2010, Rural health centres, communities and malaria case detection in Zambia using mobile telephones: a means to detect potential reservoirs of infection in unstable transmission conditions. Malaria J, Apr 15, 9(96)
Kiszewski et al 2007, Estimated global resources needed to attain international malaria control goals, Bulletin WHO, 85(8).
Yamana et al 2010, Early warnings of the potential for malaria transmission in rural Africa using the hydrology, entomology and malaria transmission simulator (HYDREMATS). Malaria J. Nov 12, 9(323).
Coordinator for African Malaria Coalition
President of Boston Harbor Publishers
970 560 1182