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World Malaria Day - 25 April 2012

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Each year, 25 April is designated as World Malaria Day, so now is a good time to review the progress being made towards the elimination of malaria, and in particular Pageant's small part in helping to combat this killer disease.

There are about 216 million cases of malaria world-wide each year, leading to around 655 thousand deaths. The fight against malaria means that the map showing countries where malaria is endemic has been shrinking for the past decade. In Africa deaths have been cut by one third in the last decade. There are Millennium Development Goals, which aim to achieve near-zero deaths in malaria-endemic countries by 2015. The great worry now is the emergence of drug resistant strains of the malaria parasite Plasmodium falciparum, which if unchecked could lead to untreatable malaria, and a reversal of the gains made so far. So despite the current economic climate, governments and aid agencies need to keep funds flowing to malaria control programmes, and to research into new and improved methods of malaria control.

Pageant's small part in the fight against malaria in The Gambia consists of distributing mosquito nets to village communities, and encouraging the cultivation of Artemisia Annua Anamed, from which people can prepare a 'tea' with proven anti-malarial properties. Both mosquito nets and Artemisia plants are included in Pageant's Ethical Gifts scheme, so everyone can help in the fight against malaria.

Resistance to Artemisinins

Chloroquine used to be the main drug for malaria control, but it is now ineffective in most areas because the Plasmodium falciparum parasites have developed resistance, and many other antimalarials are becoming less effective. The world's main treatment is now Artemisinin Combination Therapy (ACT), a combination of Artemisinin (derived from the Artemisia Annua herb) with one or more of the older drugs. Unfortunately the Plasmodium falciparum parasite has developed resistance to ACT in Thailand and Burma. There are worries that resistance could spread to sub-Saharan Africa, leading to untreatable malaria. [more info] [and more]

There are several approaches to attacking the resistance problem:

  • Research on the parasite genome has revealed an area which is  linked to resistance. This could lead to a better understanding and therefore prevention of resistance developing.

  • The World Health Organisation (WHO) is working on a containment project to eliminate the resistant parasite from the areas where it is now endemic. [more info] [and more]

  • WHO also felt that use of Artemisinin alone (Artemisinin monotherapy) could be one of the causes of resistance so recommended a ban on monotherapies in 2006. So far only Cambodia has implemented a ban.

Resistance to Artemisia Tea

Fake and substandard anti-malarial drugs are widely on sale throughout Africa, and some contain only small amounts of Artemisinin. It is thought that the use of these could lead to resistance developing independently in Africa. [more info] Is there any chance that using Artemisia tea could contribute to the development of resistance? In China the herb Artemisia Annua has been used as an anti-malarial for some 2000 years, without any resistance developing. There doesn't seem to be any evidence that parasites become resistant to whole plant extracts. For example, the malaria parasite has developed resistance to synthetically made Chloroquine, but tea made from the bark of the cinchona tree is still effective. [more info] [and more] Until there is convincing evidence against using artemisia tea, Pageant will continue to promote its Artemisia Project as part of the fight against malaria.

Mosquito Nets

Malaria is transmitted by the anopheles mosquito, so if drugs do become less effective, then prevention of infection using mosquito nets becomes even more important. Nets are always treated with an insecticide, so that as well as forming a physical barrier, they actually kill mosquitoes by contact. Conventional insecticides need to be reapplied during the lifetime of the net, and failure to do this means that the nets become less effective. There are now long lasting insecticide treatments (LLIN) which are good for about 5 years, at which point the net would probably need replacing anyway. These are usually applied during manufacture, and the insecticide can be chemically bonded to the fibre. [more info on LLIN]

Biotech Solutions

Effective control of many insect pests has been achieved by releasing large numbers of sterile males. These mate with females, who then fail to produce any offspring. This technique is particularly effective for insects where the female mates once only. An example is the screwworm, a parasite which infects many types of grazing animal. This has been largely eliminated in many areas, by releasing large numbers of males which have been sterilised by radiation. Similar methods are being tried on the anopheles mosquito. A variation is to produce genetically modified males, which are not sterile, but whose offspring only survive for a very short time. [more info]

Not just in Africa

Just in case you thought that malaria was confined to tropical countries, it is worth remembering that it was once endemic here in Britain. In Romney Marsh, Kent, malaria was known as 'marsh fever', and killed large numbers of people in the middle ages. It was only finally eradicated in the early twentieth century, Mosquitoes capable of carrying malaria still exist in Romney Marsh and other marshy areas of Britain. It only needs some infected people to be bitten for the disease to re-establish itself. So please support World Malaria Day, if only out of self interest! You can do your small part by purchasing a Pageant Ethical Gift such as a mosquito net or some artemisia plants.


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