Clinical Review Science, medicine, and the future

Malaria

BMJ 2002; 325 doi: https://doi.org/10.1136/bmj.325.7374.1221 (Published 23 November 2002) Cite this as: BMJ 2002;325:1221
  1. Christopher J M Whitty, senior lecturera,
  2. Mark Rowland, senior lecturera,
  3. Frances Sanderson, Lister senior fellowb,
  4. Theonest K Mutabingwa, senior lecturerc
  1. a Gates Malaria Partnership, London School of Hygiene and Tropical Medicine, London WC1B 3DP
  2. b Nuffield Department of Medicine, John Radcliffe Hospital, Oxford OX2 9DU
  3. c National Institute of Medical Research, PO Box 96, Dar-es-Salaam, Tanzania
  1. Correspondence to: C J M Whitty
  • Accepted 9 September 2002

Prevention of malaria requires a combination of laboratory and operational research and political will to provide affordable effective drugs

Summary points

Malaria kills millions of people every year

Basic scientific research is advancing rapidly in many disciplines; research with immediate practical applications in endemic countries is moving more slowly

Novel ways of deploying insecticides and impregnated nets are effective, but new insecticides are needed

Vaccine research is moving fast, but a vaccine for deploying in endemic areas is some way off

Increasing drug resistance in South East Asia has been countered with drugs containing artemisins

As resistance spreads in Africa the key challenge is to find affordable drugs

Introduction

Malaria is one of the leading causes of morbidity and death worldwide, with over 100 million cases and at least a million deaths a year. Most of these deaths are in the poorest regions of the world. Because malaria is a highly complex disease, the diversity of research to prevent and treat it is probably greater than for any other disease. It ranges from modelling climate change and satellite data to predict epidemics through to elucidating the genome sequence of the malaria parasite Plasmodium falciparum and the mosquito vectorAnopheles gambiae.15 The cultural diversity and poverty of seriously affected populations in Africa, Asia, and South America present particular challenges. Here social science, especially anthropology and economic research, have as important a role as traditional laboratory work. Malaria research is exciting because it is rapidly moving and cross disciplinary. It is also depressing, as the spread of drug resistant parasites, extreme poverty, and the collapse of health services under the impact of HIV or war undermine much of this progress.

Sources and selection criteria

We focus on three areas of malaria research that are developing rapidly and are likelyto have an impact in endemic areas …

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