Team:TrinityCollegeDublin/Future

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The Future of Malaria

Introduction

We have come far in the past century regarding treatment of malaria. With a number of therapeutic drugs available, the chances of escaping the clutches of malaria are now higher than ever before. Here, we take a look at what the future holds for malaria.

Re-thinking the global distribution

One of more chilling thoughts regarding the future of malaria is its spread beyond the areas that it currently occupies. Malaria now predominantly occurs in countries that are at or near the equator. This includes a thick band of countries on the African continent, as well as parts of South America and countries in south and south-east Asia. These are the regions that are traditionally associated with the disease because their tropical climates help to support the mosquito populations that carry the malaria-causing parasite. Those countries that are located outside that band around the center of the globe assume themselves to be safe.

However, the Earth is getting warmer. According to NASA’s website, the global temperature has increased by about 1.4 F since 1880. As well as rising sea levels, this has the potential to lead to the spread of malaria beyond the band that it currently occupies. This means that malaria will begin to occur in parts of Europe and North America and cause an extra risk to the health of these populations.

Funding

In order to combat malaria, we need money. The funding for the control and elimination of malaria in 2013 was 2.7 billion US dollars which is below the 5.1 billion that was estimated to be needed. 72% of that funding was supplied by WHO African Region. This seems natural because the majority of cases of malaria occur in Africa.

However, to reach the target of 5.1 billion US dollars that is needed, more regions that are at risk of malaria such as south-east Asia should provide funding and not place the burden on African countries alone. Funding should be significantly increased in the future in order to ensure that malaria is adequately controlled and possibly even eradicated forever like the smallpox virus.

Vector-Controlling Future

The last decade has seen a significant increase in the use of vector controlling methods to prevent infection with malaria. Vector control is where the population of the malaria spreading vector, the mosquito, and its access to people is controlled. For example the use of insecticide-treated mosquito nets (ITN) is a very popular method of vector control. Today, 43% of the population that is at risk sleeps under these nets, which is a significant increase from only 2% in 2004. Sleeping under these nets significantly reduces the risk of being bitten by parasite carrying mosquitos. In the future, more of these nets should be provided to people in at risk regions of the world.

For the future of GMO’s in the atmosphere, when it comes to making mosquito species that cannot carry the plasmodium parasite or eliminating a certain mosquito species completely by genetic modification, Kay Monroe concluded that : (People) are concerned about creating Franken-monster mosquitoes or something ridiculous like that. We need to do a lot more communication at the lay person level to make sure people understand what’s going on to explain to them about GMOs.

Other drugs and the future of SSA

Both Chris Paddon and Kathleen Monroe shed some light on future projections when it comes to combating Malaria with different drugs as well as on the future of SSA and plant based artemisinin to fight the disease in the coming years. Chris mentioned that the Gates foundation funded some other projects like the one in University of York in the UK where they’re actually developing higher production plants capable of producing more artemisinin.

Kay Monroe went further on to talk about future prospects in the drug industry: There is really amazing technology about state-of–the-art drugs but it’s very expensive so they can’t be used in the developing world right now. The WHO is well aware of this, trying to address it. The manufacturers have to work at a level where they make the drug and package it... With 3D printers you can do pretty much anything. A US drug just got made through 3D printing. But then again such and other kinds of advanced technology is very difficult to implement in the developing world.

She also mentioned about MMV- Medicines for Malaria Venture, who have a portfolio of drugs that have a different mechanism of action from artemisinin and are currently in phase 2 and 3 drug trials. They are to be released in the market in 3 to 5 years. When it comes to growing Artemisia plants, she said that it will easily stay in the market for the next 10 to 20 years as people can still grow it to make their own money, but overall it is going to be a much smaller proportion of it in the overall market.

Ingrid Chen of Malaria Elimination Initiative, sums it up nicely by saying that: It makes sense to use nature where we can. However, I still think that it’s great that they found another way to make artemisinin especially when the natural crop yield fails.