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War on malaria

MOSQUITO-BORNE malaria kills 2 million people each year -- mostly African children -- and infects more than 300 million others. Those numbers are bound to increase because the malaria parasite and mosquitoes are increasingly drug resistant.

"Beyond the extraordinary human toll, malaria is one of the greatest barriers to Africa's economic growth, draining national health budgets and deepening poverty," Bill Gates said recently in announcing grants totaling $168 million to fight malaria.

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This new infusion of research dollars -- a pittance compared with money going into finding a cure for AIDS, another scourge devastating Africa -- is very good news. But finding a pharmaceutical solution to malaria will likely require patience, determination and a measure of luck as well as money.

Just ask researchers at East Baltimore's Johns Hopkins Bloomberg School of Public Health, which received an anonymous $100 million gift to establish a Malaria Research Institute two years ago. They are working not only on drug development, but on home-based malaria diagnosis kits as well. They are even trying to create a "death" virus to kill mosquitoes. But progress is slow because malaria is a complicated disease.

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One powerful weapon already available for the war against malaria is considered too dangerous to use. DDT, the pesticide that eradicated malaria across Southern Europe in the 1950s and 1960s, was widely sprayed in Africa until the late 1970s when it was banned because of its harmful effect on the environment.

In desperation, a few countries -- led by South Africa -- have reintroduced a limited use of DDT. "It's a trade-off," one official said of the pesticide, which kills mosquitoes indoors and is effective even if sprayed only a few times a year.

Quinine, originally made from the bark of the South American cinchona tree, also is making a comeback as a malaria drug. It fell into disfavor after synthetic alternatives were developed, but turns out to be more effective toward resistance-prone mosquitoes. In the absence of a predictably effective medicine, African countries should vigorously encourage practical preventive measures, including anti-malaria education, the use of mosquito nets over beds and improved hygiene.

Such steps were instrumental to Baltimore's success in eradicating malarial fevers in the 1890s; until then, there were frequent summertime epidemics. The disease virtually disappeared once officials discovered that mosquitoes thrived in pools of fetid water, and moved to rid the city of those breeding grounds.


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