1. Comment on how realistic you think the goal is of eliminating malaria as a public health problem.

Since malaria was first officially diagnosed as being caused by the parasite Plasmodium falciparum, doctors and researchers have searched endlessly for a cure. Countless man hours, and dollars, have been spent on this quest. While the race has been neck-to-neck for decades, humans are finally beginning to take the lead, with an arsenal of new technologies to throw at their microscopic but prolific enemies. While the prospects look good, however, the battle is not over yet, and based on past experiences, the outcome of malaria eradication is far from certain.

In the 19th century a breakthrough in combating Malaria came with the discovery and medicinal application of chloroquinine, a cheap extract of the plant extract quinine (Levy, 2007, p.817). Chloroquine still has the honor as being the most effective combatant against malaria. However it, along with the second most effective attach agent, DDT, were both no match for P. falciparum. The parasite itself quickly developed resistant strains to chloroquine and its vector, the mosquito, did the same with DDT. The same story has played out with different anti-malarial drugs, including sulfadoxine-pyrimethamine and mefloquine. Alarmingly, this additional resistance of the parasite to treatments has resulted in an “increase in morbidity and mortality due to malaria (Olliaro and Wells, 2009, p. 584).”
Strides have been made in the battle against malaria and in developed nations such as Europe and the U.S., where the disease has been all but eradicated. The means by which successful eradication has taken place has been through an understanding of the disease, educating the public on ways to avoid coming into contact with it (i.e. avoiding mosquitoes, wearing protective clothing, using bug spray, etc.), and better public sanitation. For those that do contract the disease in one of these nations, they have a complete medical arsenol at their disposal. Patients in developed nations will typically be given a combination of drugs that are administered in a hospital setting. This is in stark contrast to developing nations, where sanitation is worse, there are naturally more mosquitoes, the public has less education on the disease and avoiding it and there are fewer funds to treat those effected.

Advances in technology, understanding of the life cycle of both the parasite and its host and leaps in scientific thinking have lead to new strategies in combating the disease. Based on past lessons, it is evident that malaria will not succumb to a simple vaccine, pesticide or treatment. In order to combat malaria, an innovative new approach using genetic technology is being considered for use in combating malaria. This experimental technology, however, is still young and only time will tell if malaria P. falciparum will find a way to surmount this hurdle as well as it has in the past.

2. Given the current level of scientific knowledge, what do you the think are the major barriers of reaching such a goal?

There are many barriers that stand in the way of achieving the goal of eradicating P. falciparum and the malaria it causes. One of the main barriers is the understanding of the factors that lead to genetic resistance itself. Studies have shown that P. falciparum can form a resistance to single treatment medicines quickly, leading researchers to instead experiment with combined medicines that target the parasite at various stages throughout its life cycle. This has led to some success, and in 2009 21 new medicines were in the pipeline, with 6 ready to begin clinical trials in that year (Olliaro and Wells, 2009, p. 587). research has led to a better understanding of the life cycle of P. falciparum and this had led to the possible surmounting of one of the barriers.

Yet, still little is known about the modes of transcript within DNA which allow for such useful and novel resistances to medicines and pesticides by organisms such as P. falciparum and is mosquito vectors. Resistance begins to show up so soon after a treatment is introduced, in some cases as little as 2 years, proving the efficiency at which the organism is able to develop a way of combating its attacker. This barrier, however, it one that is under the intense scrutiny of researchers, and if they have their way, it will be one barrier that will soon come crashing down. One hopeful field of research that is currently underway to create a strain of mosquito that is resistant to the P. falciparum. The hope is that by introducing this modified mosquito strain into ecosystems where malaria is prevalent, it will interbreed with the malaria vectors, eventually eliminating them from the environment.

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