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Africa, China, General

Winning the Battle Against Malaria

Although the U. S. Navy and the William and Melinda Gates Foundation are seeking vaccines to eliminate the scourge of malaria, China has this month experimentally managed to cure malaria in one relatively large African population cluster.

Malaria has long been endemic in the Comoros, a very poor, three-island nation off Africa’s east coast. About 90 percent of its 1 million people, most of whom speak French and Arabic, have long been infested with the parasite that lives in a human’s bloodstream and provides a renewable source for mosquito-borne transmission from human to human. Malaria causes high fevers, bone-breaking pain, and – in rare cases of cerebral malaria – death.

This month a Chinese company successfully completed an unusual trial of Artequick, a new anti-malarial drug that prevents the parasite from causing harm. By dosing an entire country, albeit a small, isolated one, Artequick’s manufacturer was able dramatically to establish the drug’s efficacy. No one has ever before tried to end malarial infections by a sustained and contained attack on a designated subject population.

Artemesinin, a well-known and well-tolerated remedy for malaria, is a key component of Artequick. Derived from sweet wormwood, an herb used in traditional Chinese medicine, it has for about a decade been the medicine of choice in the combat of malaria.

In the Comoran experiment, Artequick was delivered together with low doses of Primaquine, an existing anti-malarial medicine with serious known risks and side-effects.

Three times over the course of three months everyone in the Comoros took Artequick together, thus rapidly depriving mosquitos of any hosts and hence stopping malarial transmission in its tracks. Three months is the length of the life-style of the Aenophoeles mosquitoes that take the plasmodium falciparum parasite from person to person. Once no human hosts existed, malaria could not be spread and the scourge removed from the Comoros.

That is what seems to have happened, as the Chinese scientists behind the experiment predicted. If malarial infections have thus been ended for good in the Comoros, the Artequick method ought soon to supersede the traditional approach to malaria: killing mosquitoes by spraying houses and bed-nets with insecticide and providing prophylactic pills to forestall the action of the prime parasite.

A professor of Chinese medicine in Guangzhou explained that it was better to “kill the parasites in the people” rather to try to kill every mosquito. “We changed the idea,” he said.

The Comoros government says that the successful Chinese experiment should save his country $11 million a year in health costs, not to mention the regained productivity of a population that will now be healthy – thanks to China’s ingenious efforts.

Artequick, however, has neither been tested nor approved by the World Health Organization or experts in tropical medicine. The drug itself, manufactured by Artepharm in China, is a combination of existing drug remedies. Its toxicity and side effects are not yet known, although Primaquine’s ability to rupture red blood cells is well documented. In the Comoros, hospitals noticed an unexplained doubled uptake in patients in the first weeks after Artequick was first administered.

In addition to those potential dangers, scientists will also have to decide whether the benefits of eliminating malarial transmission in a subject population outweigh a concern that malaria will someday return and find a population with no immunity, or a population that will have become artemesinin-resistant.

If, over the course of the coming southern hemisphere summer, when mosquitoes bite wildly and malarial attacks usually spike, the people of the Comoros remain blessedly free of malarial fevers and without harmful side-effects, then the Chinese method will have proven its worth. At that point, the experiment can be replicated and, just possibly, malaria could become one of those terrible diseases of the past.

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