Malaria meeting comes at a key point in the history of efforts to overcome a killer infection

31 Oct 2009

Paul Chinnock

Source: TropIKA.net

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A major gathering of malaria specialists will highlight the role of African leadership in the battle against the disease, which is responsible for some 880,000 deaths, every year. Most of those who die are African children.

Held over six days (1st to 6th November), the 5th Multilateral Initiative on Malaria (MIM) Pan-African Malaria Conference is the biggest event of its kind. Over 1500 people are attending. It is the first such meeting since 2005, when the event took place in Yaoundé, Cameroon. Meanwhile, much has happened, in terms both of scientific advances and increased funding for research and control efforts. The elimination of malaria as a public health problem is now back on the agenda.

Interventions to prevent and control malaria have been much expanded, particularly the use of artemisinin combination therapies (ACTs) and the distribution of insecticide-treated bednets (ITNs). Efforts are now being made to improve the management of cases of fever through the introduction of rapid diagnostic tests (RDTs) which can confirm suspected malaria at primary health care level.

The Global Fund to Fight AIDS, Tuberculosis and Malaria (GFATM) has in its latest round of funding approved more grants for malaria than for AIDS and tuberculosis combined. Politicians and celebrities have also engaged with malaria control as an issue, and the intensive media coverage which has resulted is likely to prove beneficial.

But there are worries about resistance to drugs – after artemisinin there are no new drugs in the development pipeline – and to insecticides. Economic and political problems could also so easily derail the encouraging progress seen in recent years.

The research presented at MIM 2009 is therefore of considerable importance and TropIKA.net has a team of journalists and rapporteurs at the meeting, who will provide up-to-date online coverage. As always, comment and feedback from users of on TropIKA.net will be welcomed. Follow this link to participate in the conference online.

Scientists interviewed

In the lead-up to the conference, TropIKA.net has published interviews with ten researchers who will be making key presentations at MIM 2009. The scientists interviewed are working on a range of topics including: the integrated management of childhood infections, the impact of RDTs, the measurement of efficacy in vaccine trials, drug and insecticide resistance, and genomic research. The interviews may be accessed in full here.

An important theme emerging in the comments of several of the researchers interviewed is uncertainty over what is responsible for the declines in malaria case numbers that have been reported from many parts of Africa. While these declines have been widely attributed to ACT use and ITN distribution, it may well be that we are seeing a continuation of a downward trend that was already present before the new interventions were introduced.

It is also possible that malaria is considerably over-diagnosed. Several of the researchers commented on the widespread belief amongst health workers that “any fever is malaria”. The recent global focus on malaria may have reinforced this misconception. Rather than concentrating on killing the malaria parasite, do we need to think more in terms of treating the child with fever? Often such a child has malaria plus other infections (such as pneumonia or diarrhoea), but may not actually have malaria at all.

Some of the views expressed in these TropIKA.net interviews could therefore be controversial. Our reporters in Nairobi will be seeking the reactions of young African scientists and senior figures in malaria control organisations. We will be publishing these interviews also. The aim is to stimulate further debate, both in Nairobi and beyond. Every article published on TropIKA.net features our “Comment” function. Registered visitors to the website can sign in and express their own views.