malaria: a grand challenge

Preface

Malaria: a grand challenge

Whether it is the parasite that becomes resistant to

traditional treatments, the mosquitoes that develop resist-

ance to the insecticides, political and social upheavals

resulting in displacement of people living in areas of high

transmission, or natural and man-made changes in the

environment which create new breeding ground for

mosquitoes, it is an inescapable observation that the number

of people dying from malaria is now higher than ever. The

WHO estimates that more than 2 billion people are at risk of

malaria and that, annually, between 300 and 500 million

persons are infected annually, which results in severe

complications during pregnancy and in the deaths of more

than 2 million people, mainly young children.

More than 90% of all malaria cases globally occur in sub-

Saharan Africa and Plasmodium falciparum alone accounts

for more than 3000 deaths every day. During a recent visit to

Africa, the Microsoft chairman, Bill Gates, said ‘Malaria is

robbing Africa of its people and potential,.’ and that

‘Beyond the extraordinary human toll, malaria is one of the

greatest barriers to Africa’s economic growth, draining

national health budgets and deepening poverty’. The

situation in many other malaria endemic regions is further

complicated by equally dominant representation of malaria

infections caused by Plasmodium vivax, a species that

causes relapsing malaria.

Implementing traditional malaria control strategies has

become more challenging, even in the regions with

resources sufficient to sustain such efforts. Costs associ-

ated with drug development are a further concern. The

greatest public health success story of the past century, i.e.

childhood immunisation against communicable diseases,

provided the impetus for research into the development of

malaria vaccines which could offer an effective and cost-

permissive public health intervention strategy. Improve-

ments in controlling the mosquito vector, the development

of new generation anti-malaria drugs and production of

effective vaccines continue to challenge scientists. To this

end, explosive growth in genomic information has opened

ways to look at this ancient disease in new ways, and

raises the question of whether effective control of malaria

is now more feasible than ever. While vaccines can

prevent viral and bacterial infections, vaccines against

uni- and multi-cellular parasites still remain to be realised;

0020-7519/$30.00 q 2004 Australian Society for Parasitology Inc. Published by

doi:10.1016/j.ijpara.2004.11.001

and their development continues to offer formidable

challenges.

The Second International Conference on Malaria (March

24–26, 2004) organised by the Johns Hopkins Malaria

Research Institute reflects an effort to develop and expand

partnerships among leaders in the field for success in

combating malaria. This thematic issue contains a sample of

some of the presentations (authors identified in italic) made

at the meeting. A full range of presentations included those

on Parasite Genetics and Biology (Karen Day, Ananias

Escalante, Andrew Waters, Joe DeRisi, Alan Cowman,

Kasturi Haldar, Nirbhay Kumar), Parasite Interactions with

Mosquito Vector (Andrew Read, Hilary Hurd, George

Christophides, Marcelo Jacobs-Lorena, Robert Sinden,

David Rogers) and Malaria Prevention and Treatment

(Artur Scherf, Elanor Riley, Fidel Zavala, Socrates Herrera,

Mary Stevenson, Sungano Mharakurwa, Hernando Del

Portillo, Vern Schramm, Philip Rosenthal, Michael Gelb).

The other significant highlights of the meeting were a

keynote lecture by Louis Miller, a special lecture by 2003

Nobel Laureate Peter Agre of Johns Hopkins University and

a poster session (32 posters). The evening reception during

the poster session provided an opportunity for open relaxed

discussions on current findings.

The organisers hope that the meeting facilitated an open

dialogue and discussion on a wide range of topics. The

enormity of problem caused by the resurgent malaria

parasite will require complex and highly coordinated

approaches to mount effective disease prevention cam-

paigns. Basic understanding of the mechanisms by which

parasites develop in the mosquitoes and are successfully

transmitted to susceptible hosts; the means by which

parasites selectively target certain host cells for their

survival; the ways in which the host reacts to the presence

of infection; the impact of control programmes on

transmission patterns; novel methods to detect organisms

(among other topics) represent some of the challenges that

lie ahead. It is hoped that the meeting will stimulate further

progress which will pave the way for novel ways to tackle

the problem of public health concerns caused by malaria.

The participants appreciated the importance of the con-

tinuity of the exchange of ideas and the organisers hope that

the next such meeting will not only provide a venue for

International Journal for Parasitology 34 (2004) iii–iv

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Preface / International Journal for Parasitology 34 (2004) iii–iviv

taking stock of the malaria situation then, but hopefully, be

closer to the goal of having better ways to diagnose, treat

and control this invidious disease.

Acknowledgements

My thanks to all the speakers and the approximately 300

other participants of the meeting who made this conference

a success. The organising committee and other support staff

worked very hard to ensure that the meeting organized in the

brand new auditorium ran without any technical problems.

I would fail in my efforts if I did not thank all the

contributors to this special issue, the reviewers for their

constructive and timely reviews and Susan Booker and

Maryann Brooks for facilitating exchange of information

*Tel.: C1 410 955 7177; fax: C1 410 955 0105.

with the authors and the reviewers. Knowing the amount of

effort it takes to put together an issue like this, I was

encouraged by enthusiastic support of the International

Journal for Parasitology staff. In particular, my very special

thanks go to Nicholas Sangster, Editor-in-Chief and ever

diligent and patient Maria Meuleman. The meeting was

supported by funds from the Johns Hopkins Malaria

Research Institute.

Nirbhay Kumar*

Department of Molecular Microbiology and Immunology,

Johns Hopkins Malaria Research Institute, Johns Hopkins

University Bloomberg School of Public Health,

Baltimore, MD 21205, USA

E-mail address: nkumar@jhsph.edu