Malaria might be eliminated from countries it has plagued for centuries, according to malaria experts who gathered for the Bay Area World Malaria Day Symposium on April 25 at the UCSF Mission Bay campus.
Laboratory researchers, inventors, drug developers, public health professionals and advocates came to discuss the innovations and dedication needed to accomplish such an ambitious task. Currently, more than 200 million people worldwide are infected with the mosquito-borne parasite that causes malaria.
Wide-ranging Malaria Research at UCSF
Malaria engages dozens of researchers at UCSF. Faculty, fellows and students who tackle the disease range from laboratory scientists who track the life cycle of the common malaria parasite Plasmodium falciparum to better understand the disease and to generate new ideas for how to target the parasite; to scientists who develop better tools for tracking the spread of malaria and drug resistant variants; to public health scientists who formulate and test new ways to implement successful campaigns for the detection, treatment and elimination of the disease.
Keynote speaker Jay Keasling, PhD, a UC Berkeley professor and associate director of the Physical Biosciences Division at Lawrence Berkeley National Laboratory,is an expert in synthetic biology, research in which microbes are turned into factories to improve production of useful chemicals.
Keasling described how the most effective antimalarial drug — artemisinin — now can be made not only by farmers, but also with the aid of brewer’s yeast, which through the wonders of synthetic biology has been re-engineered to cheaply churn out the key ingredient.
Keasling founded a company, Amyris, which has pioneered the use of microbes that make artemisinic acid, a precursor of artemisinin, and he talked about further advances in making the drug.
Artemisinin now is coupled with other treatments in combination therapies aimed at lessening the likelihood that the malaria parasite will develop drug resistance.
Scale-up of artemisinin manufacturing by Sanofi is underway, the result of a partnership that includes Amyris, the non-profit drug-development program One World Health, The Bill and Malinda Gates Foundation and UC Berkeley, among others.
Sanofi is gearing up to make up to 45 tons of artemisinin in 2013, and more in later years. According to Elena Pantjushenko, external affairs associate for One World Health, the goal is to achieve an adequate supply at a fair-market price below the current market price, but still high enough to keep farmers in the market.
Malaria Control and Innovation
In other research, scientists have been inventing portable, inexpensive tools, such as aps for cell phones, to aid in diagnosis and disease tracking in the field. Other speakers described drug discovery efforts aimed at finding unexploited vulnerabilities in the form of the parasite that invades human blood cells.
Counterfeit drugs have hampered malaria control efforts. Peter Wong, chief operating officer for TruTag Technologies Inc., described how the company is using an FDA-accepted substance, silica, as an authenticity label to thwart drug counterfeiters.
UCSF assistant professor of medicine Bryan Greenhouse, MD, described strategies for tracking genetic changes in the malaria parasite in human populations to make better public health decisions about how to focus malaria control efforts. The method has been used to track other diseases, and Greenhouse now has begun to successfully use it to track new malaria cases in Zanzibar.
Several speakers described the implementation of campaigns, programs, and policies. These include advocacy campaigns and resources to increase awareness of malaria, domestic and international programs that build capacity for malaria prevention, and policy recommendations to sustain the gains in malaria control and elimination.
Like the Avon ladies of yesteryear, 700 sellers are going door to door in Uganda, offering malaria screening along with soap, cleaning supplies and other household items. In other non-profit efforts, sports teams in the United States are gathering money for bed nets, while faith-based groups are organizing their own contributions to malaria control efforts.
Recently, there has been a greater than 50 percent reduction in malaria cases and deaths in several sub-Saharan African nations where malaria control efforts have been sustained for many years.
UCSF Global Health group researchers Gavin Yamey, MD, MPH, and Chris Cotter, MPH, described research showing that lapses in control efforts have historically played a larger role than other factors in driving malaria resurgences, and cited funding reduction as a major threat to recent successes in controlling the disease.
Michele Barry, MD, the senior associate dean of global health and director of the Center for Innovation in Global Health at Stanford University, offered closing remarks.
During an interview before the symposium Barry said, “Mostly, we have talked about suppressing or controlling malaria. We haven’t really talked about eradication. I think this conference brings together a group of people in the Bay Area who are working on ways to eradicate malaria.”
Jaime Sepulveda, MD, MPH, DSc, the executive director of UCSF Global Health Sciences and a former director of Mexico's National Institutes for Health, opened the symposium and called for greater efforts on the part of the Bay Area community of researchers and advocates to strengthen their impact in fighting the disease internationally.