malaria: a grand challenge
TRANSCRIPT
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Preface
Malaria: a grand challenge
Whether it is the parasite that becomes resistant to
traditional treatments, the mosquitoes that develop resist-
ance to the insecticides, political and social upheavals
resulting in displacement of people living in areas of high
transmission, or natural and man-made changes in the
environment which create new breeding ground for
mosquitoes, it is an inescapable observation that the number
of people dying from malaria is now higher than ever. The
WHO estimates that more than 2 billion people are at risk of
malaria and that, annually, between 300 and 500 million
persons are infected annually, which results in severe
complications during pregnancy and in the deaths of more
than 2 million people, mainly young children.
More than 90% of all malaria cases globally occur in sub-
Saharan Africa and Plasmodium falciparum alone accounts
for more than 3000 deaths every day. During a recent visit to
Africa, the Microsoft chairman, Bill Gates, said ‘Malaria is
robbing Africa of its people and potential,.’ and that
‘Beyond the extraordinary human toll, malaria is one of the
greatest barriers to Africa’s economic growth, draining
national health budgets and deepening poverty’. The
situation in many other malaria endemic regions is further
complicated by equally dominant representation of malaria
infections caused by Plasmodium vivax, a species that
causes relapsing malaria.
Implementing traditional malaria control strategies has
become more challenging, even in the regions with
resources sufficient to sustain such efforts. Costs associ-
ated with drug development are a further concern. The
greatest public health success story of the past century, i.e.
childhood immunisation against communicable diseases,
provided the impetus for research into the development of
malaria vaccines which could offer an effective and cost-
permissive public health intervention strategy. Improve-
ments in controlling the mosquito vector, the development
of new generation anti-malaria drugs and production of
effective vaccines continue to challenge scientists. To this
end, explosive growth in genomic information has opened
ways to look at this ancient disease in new ways, and
raises the question of whether effective control of malaria
is now more feasible than ever. While vaccines can
prevent viral and bacterial infections, vaccines against
uni- and multi-cellular parasites still remain to be realised;
0020-7519/$30.00 q 2004 Australian Society for Parasitology Inc. Published by
doi:10.1016/j.ijpara.2004.11.001
and their development continues to offer formidable
challenges.
The Second International Conference on Malaria (March
24–26, 2004) organised by the Johns Hopkins Malaria
Research Institute reflects an effort to develop and expand
partnerships among leaders in the field for success in
combating malaria. This thematic issue contains a sample of
some of the presentations (authors identified in italic) made
at the meeting. A full range of presentations included those
on Parasite Genetics and Biology (Karen Day, Ananias
Escalante, Andrew Waters, Joe DeRisi, Alan Cowman,
Kasturi Haldar, Nirbhay Kumar), Parasite Interactions with
Mosquito Vector (Andrew Read, Hilary Hurd, George
Christophides, Marcelo Jacobs-Lorena, Robert Sinden,
David Rogers) and Malaria Prevention and Treatment
(Artur Scherf, Elanor Riley, Fidel Zavala, Socrates Herrera,
Mary Stevenson, Sungano Mharakurwa, Hernando Del
Portillo, Vern Schramm, Philip Rosenthal, Michael Gelb).
The other significant highlights of the meeting were a
keynote lecture by Louis Miller, a special lecture by 2003
Nobel Laureate Peter Agre of Johns Hopkins University and
a poster session (32 posters). The evening reception during
the poster session provided an opportunity for open relaxed
discussions on current findings.
The organisers hope that the meeting facilitated an open
dialogue and discussion on a wide range of topics. The
enormity of problem caused by the resurgent malaria
parasite will require complex and highly coordinated
approaches to mount effective disease prevention cam-
paigns. Basic understanding of the mechanisms by which
parasites develop in the mosquitoes and are successfully
transmitted to susceptible hosts; the means by which
parasites selectively target certain host cells for their
survival; the ways in which the host reacts to the presence
of infection; the impact of control programmes on
transmission patterns; novel methods to detect organisms
(among other topics) represent some of the challenges that
lie ahead. It is hoped that the meeting will stimulate further
progress which will pave the way for novel ways to tackle
the problem of public health concerns caused by malaria.
The participants appreciated the importance of the con-
tinuity of the exchange of ideas and the organisers hope that
the next such meeting will not only provide a venue for
International Journal for Parasitology 34 (2004) iii–iv
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Preface / International Journal for Parasitology 34 (2004) iii–iviv
taking stock of the malaria situation then, but hopefully, be
closer to the goal of having better ways to diagnose, treat
and control this invidious disease.
Acknowledgements
My thanks to all the speakers and the approximately 300
other participants of the meeting who made this conference
a success. The organising committee and other support staff
worked very hard to ensure that the meeting organized in the
brand new auditorium ran without any technical problems.
I would fail in my efforts if I did not thank all the
contributors to this special issue, the reviewers for their
constructive and timely reviews and Susan Booker and
Maryann Brooks for facilitating exchange of information
*Tel.: C1 410 955 7177; fax: C1 410 955 0105.
with the authors and the reviewers. Knowing the amount of
effort it takes to put together an issue like this, I was
encouraged by enthusiastic support of the International
Journal for Parasitology staff. In particular, my very special
thanks go to Nicholas Sangster, Editor-in-Chief and ever
diligent and patient Maria Meuleman. The meeting was
supported by funds from the Johns Hopkins Malaria
Research Institute.
Nirbhay Kumar*
Department of Molecular Microbiology and Immunology,
Johns Hopkins Malaria Research Institute, Johns Hopkins
University Bloomberg School of Public Health,
Baltimore, MD 21205, USA
E-mail address: [email protected]