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We should take on the job to eradicate malaria

February 11, 2014 - 18:23 -- MESA Alliance

'The science of malaria eradication' Keystone Symposium

Thursday Feb 6th

The Keystone symposium 'The science of malaria eradication' ended with a common appreciation of bringing together scientists from completely different disciplines, but whose work is led by the singular goal of clearing malaria infection from the entire world. ìWe need to put our own work in perspective and identify what really needs to be doneî, said Chetan Chitnis (International Centre for Genetic Engineering and Biotechnology, India), one of the three scientific co-organizers, during the closing remarks that followed an inspirational talk by Peter Agre (Johns Hopkins Malaria Research Institute, USA).

The day's sessions were devoted to parasite-host interactions, and surveillance for eradication. The morning session started with Robert Sinden (Imperial College London, UK) who presented an overview of a number of basic biology research questions. Pending questions include, identifying the small parasite populations which mediate transmission across the dry season, understanding how immunity is induced and assessing the weakest points in the parasite life cycle. He also referred to innovative work looking at multiple transmission cycles, and male-female parasite sensitivity to antimalarial compounds.

With a specific focus on P. vivax, Hernando del Portillo Obando (CRESIB-ISGlobal, Spain) followed with insights into reticulocyte-derived exosomes and their potential significance in the science of malaria eradication. Contrary to the dogma, he showed new evidence that almost every cell of the immune system involved in the response to P. vivax can produce exosomes and that they are likely to play a role in remodelling the spleen. Promising applications will be explored in future work such as therapeutics and rapid diagnostic tests.

Other talks focsued on the biology of gametocytes. Oliver Billker (Wellcome Trust Sanger Instiute, UK) talked about the function of APiAP2 genes and calcium signalling pathways in gametocyte activation and development; Gabriele Pradel (RWTH Aachen University, Germany) unveiled the role of perforine-like proteins in gametocyte egress, and finally Abhinav Sinha (Gardi Medical College, India) presented work on gametocyte non-producer mutations and the discovery of a transcriptional regulator which could be taken forward as a transmission-blocking target.

Jumping from the basic biology in laboratories, to operational challenges in the field, in the afternoon session speakers and particpants discussed the role of surveillance for elimination. Based on the premise that ìeach case identified has a source that can be identifiedî, the importance of active and passive surveillance and the concept of 'effective reproductive number' were discussed.

The meeting closed with amusing and thoughtful perspectives from Nobel Laurete Peter Agre (Johns Hopkins Malaria Research Institute, USA). "Science brings people together", said Peter Agre, who reflected on his personal experiences in research. His talk made particular note of the role of young researchers, from all parts of the globe, as well as science's ability to scale international barriers and the importance of creative thinking.

Overall, 170 people from  37 different countries attended the meeting. Encouraging the audience to ìevaluate what we are doing and see how we can do betterî, Chetan Chitnis trusted that the multidisciplinary dialogue on the science of malaria eradication will continue, and that the Malaria Eradication Scientific Alliance (MESA) will be there in the future to encourage it.

This blog was written by MESA Secretariat, and posted simultaneously on MESA's blog on MalariaWorld and ISGlobalís blog.

Comments

William Jobin's picture
Submitted by William Jobin on

I am somewhat puzzled by an alliance to eradicate malaria, composed of people who seem to have little field experience in even suppressing malaria in Africa. For their general guidance, I suggest that this alliance first address some defining questions about attacking malaria in Africa:

1. How will you deal with the Resistance Treadmill?
2. How will you deal with the Immunity Dilemna?
3. How will you pick the place to start in Africa?
4. What role will African countries play in the fight?
5. How will you expand to cover the war-torn parts of Africa ?
6. How long must you suppress transmission before all of Africa is covered ?
7. How will you prevent re-infestation from outside Africa?
8. How much will it cost?
9. How will you pay for it?

These are crucial questions for a realistic approach to the fight, which we know will be long and difficult. I hope that trying to answer these questions will help the folks in MESA to see the shape of the effort needed. If we do not have some idea of the way ahead, eradication does not seem a realistic goal. Maybe we should strive for suppression until economic development makes permanent ecologic changes possible.

In one sense, I do agree with the opening remark by Frank O. Richards of the Carter Center. He said we should start in the most difficult place. So I will agree that Africa is the most difficult place, and that we should therefore start there. Every year we wait means another half a million children die from malaria.

Bill

William Jobin Director of Blue Nile Associates