Malaria strikes back

Press, 1 May 1984, Page 17

Malaria strikes back

Drug-resistant strains of malaria — already one of the world’s major killers — are spreading inexorably across the globe. The deadly strains have established themselves in South-East Asia and South America and have recently begun a steady advance across India and Africa.

Formerly under control in many areas, the disease now threatens two billion people living in more than 100 countries. Estimates suggest that there are now more than 350 million cases of malaria a year (150 million of them new ones) — a total four times the levels of the early 19705. In Africa alone, the disease kills 1 million children each year. Several factors are responsible for this disturbing development: © Spreading world poverty which deprives nations of funds for sanitation and anti-mosquito work;

© Increased movements of migrant workers and holiday makers who can carry infections;

© The establishment of resistant strains, partly due to over-use of drugs. On top of this, hopes that genetic engineers might soon develop the world’s first malaria vaccine — a along sought goal — have been questioned recently by several senior scientists.

“I believe an effective vaccine is a very long-term possibility,” says Dr Neil Brown, a malaria expert at the national Institute of Medical Research, London.

“There are so many strains of malaria parasite and each is able to alter its chemical surface and trick its way past the body’s defences. It would be a remarkable vaccine which could cope with that diversity.”

One of the most effective antimalaria drugs proved to be chloroquine. Unfortunately, it was widely overprescribed and resistant strains were first reported during the Vietnam war. By 1980, the strains had taken root in SouthEast Asia, and the northern parts of South America. Now they have been found in parts of east Africa and India. Reports show the strains are slowly spreading westward. In. these regions, doctors have been left with only two malaria drugs. One is quinine, which is

ROBIN McKIE in London on the spread across the world of drug-resistant strains of malaria.

effective but expensive, and toxic if over-administered. The other is meflogquine, newly developed and as yet not properly tested in the field.

“The solution lies with proper health care and mosquito control,” says Professor Wallace Peters, of the London School of Hygiene and Tropical Medicine. “Unfortunately that takes money which is simply not available in developing nations at present.” There is also a serious shortage of expert medical advice. “The malaria campaigns of the 1960 s not only got rid of malaria; they got rid of the need for malariologists. Now malaria is back but not the

malariologists,” says Professor Peters. Two other reasons for malaria’s resurgence are highlighted by Dr Brown. One is the widespread use of insecticides to which mosquitoes had become resistant. The other is a general drop in vigilance against malaria. The extent of the crisis was revealed even in hospitals in Britain, which has too cool a climate for parasites to survive. In 1982, more than 1500 malaria victims — returning travellers and visitors to the United Kingdom — became ill and had to be treated here. Of these, 12 died. — Copyright — London Observer Service.