Breakthroughs in malaria research may well go the way of the other 'diseases of the poor'
the yellow international vaccination card that most western tourists carry describes malaria as "a serious and sometimes fatal disease, endemic in many tropical and subtropical countries. You cannot be vaccinated against it, but you can protect against mosquito bites, and take antimalaria tablets regularly. If you get a fever within two years after your return, tell your doctor you have recently been in a malarious country."
Behind this bland warning lies a human tragedy. Malaria afflicts up to 500 million people kills over a million people a year, at least two per minute, most of them in sub-Saharan Africa. Many are too poor to have access to protection and treatment and existing drugs are rapidly losing their potency as the parasite evolves resistance to our limited pharmaceutical armoury. The warning also reflects the apathy accorded by rich nations to this 'disease of the poor'.
While the breakthrough in unravelling the genome of the malaria parasite and vector (see "Genes and dreams") is welcome, one wonders how this milestone will help the battle to defeat this dreaded disease. Unfortunately, the biggest bottlenecks lie downstream in getting funds and industrial expertise to move promising drugs and vaccines from the lab to the market. And, as experience with aids has shown in Africa, as also the infectious disease burden of the developing countries, economic forces and inadequate health infrastructure can prevent the world's poorest from benefiting from effective new treatments.
In the case of malaria, the world spends around us $ 200 each year on the disease. But this is a mere fraction of the sums made available for bioterrorism research in the wake of last year's anthrax attacks in the us, and will do little to lessen the human misery caused by malaria. It is well-known that drug development has been so skewed towards the needs of rich countries that diseases found mainly in developing countries are accorded little attention. The vast majority of the world's poor are anyway deprived of access to life saving and essential drugs (see 'Tropical Pill', Down To Earth, Vol 11 No 6, August 15, 2002).
The difficulty lies in pushing to market promising drugs and vaccines, which are seen as commercial liabilities by pharmaceuticals. For these companies, profits come from drugs that can be mass-marketed at developed world prices.
The stark truth is, if we don't bankroll the effort, we won't roll back malaria. Or for that matter any disease afflicting the poor.
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