Live Q&A: prevention or cure, what's the best approach in malaria control?

Guardian Unlimited | September 5, 2014

Is attacking the mosquito or curing the patient the best way to manage this disease? Join The Guardian debate on 11 September, 1-3pm BST

What's the best way to stop malaria? Is it to prevent the mosquito from transferring the parasite to people, or to treat the person who has the parasite in their blood? Logic suggests it's more cost-effective to focus on the former, but in low-income countries even the cost of mosquito nets is a struggle when government budgets and aid won't stretch to cover food and basic healthcare. The World Health Organisation's (WHO) 2013 malaria report said that despite impressive gains against the disease, the expansion of interventions to keep mosquitoes away from human skin had slowed due to "a lack of funds to procure bed nets".

Is it time for new innovations in combating the disease to shine? Or to focus on better training and supplies for community healthcare workers to diagnose and treat the disease? As malaria endemicity (disease intensity) is declining, is it time for a new approach?
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A new way to diagnose malaria

Over the past several decades, malaria diagnosis has changed very little.

Characterizing, controlling and eliminating residual malaria transmission

Long-lasting insecticidal nets (LLINs) and indoor residual spraying (IRS) interventions can reduce malaria transmission by targeting mosquitoes when they feed upon sleeping humans and/or rest inside houses, livestock shelters or other man-made structures.

Evaluation of universal coverage of insecticide-treated nets in western Kenya: field surveys

Current methods of delivering ITNs, i.e., one mass campaign every five years and regular distribution of ITNs from health center can barely maintain the current effective coverage. Inaccessibility and loss of physical integrity of ITNs are major hindrances to achieving and maintaining universal coverage.

Articles

Orphan Drugs vs Orphan People

The World Health Organization (WHO) has declared, "A post-antibiotic era—in which common infections and minor injuries can kill—far from being an apocalyptic fantasy, is instead a very real possibility for the 21st century". 

Malaria fight hurt by flimsy anti-DDT research

Last year, Prof Henk Bouwman of North-West University and co-authors published a paper in a respectable journal, Environmental Research, claiming that DDT spraying led to thinning of bird eggshells.

Press Release: DDT research paper exposed as "biased and erroneous"

The environmental science journal Environmental Research has published an article by nine malaria experts exposing major errors in a research paper on DDT and bird eggshells.

Wipe out malaria by wiping out worst poverty

In Southern Africa, the malaria season typically begins with the summer rains in November and ends in April. In this region, the co-ordination of malaria control efforts between neighbouring states has dramatically reduced the incidence of malaria.

Response to "DDT's pesky proponents," by Mara Kardas-Nelson

Al Jazeera's report by Mara Kardas-Nelson (DDT's pesky proponents Apr. 21, 2014) rakes over old ground and is replete with misstatements and falsehoods.

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News

Why Humans Don't Suffer from Chimpanzee Malaria

A genetic region responsible for red blood cell invasion was among a small number of areas found to differ between the genomes of malaria parasites that affect chimpanzees and Plasmodium falciparum, the parasite responsible for the deaths of more than half a million children each year.

Ebola easier to avoid than malaria - Usaid

The head of the US Agency for International Development said on Tuesday poor understanding of Ebola was undermining the fight against the epidemic, pointing out that the fever is harder to get than malaria.

Humans give malaria to mosquitoes - we need a vaccine to stop this

On Wednesday, the world marks World Mosquito Day to commemorate the 1897 discovery by British doctor Sir Ronald Ross that malaria in people is transmitted to and from mosquitoes.

EPA Pesticide Bans Threaten You and the Economy

When Rachel Carson's book, "Silent Spring", was published, filled with totally false claims about DDT, the Environmental Protection Agency looked it over and concluded she had used manipulated data.

Sanofi shipping new malaria treatment manufactured from 'semisynthetic artemisinin'

French drugmaker Sanofi has released its first batches of a malaria treatment made from semisynthetic artemisinin using a new manufacturing process that will allow it to make tons of the ingredient and so help stabilize its volatile global market.

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Research & Policies

Return of Widespread Chloroquine-Sensitive Plasmodium falciparum to Malawi

The return of chloroquine-sensitive Plasmodium falciparumto the limited area of Blantyre, Malawi, has been well demonstrated in several studies.

Insecticide-treated nets ownership and utilization among under-five children following the 2010 mass distribution in Burkina Faso

Ownership rates were high, but real access to bed nets remained limited.

Prevalence of asymptomatic malaria and bed net ownership and use in Bhutan, 2013: a country earmarked for malaria elimination

With high coverage and regular use of LLINs, and a zero prevalence of malaria infection found in historically high-risk communities during the peak malaria season, it appears Bhutan is on course to achieve malaria elimination.

In vivo efficacy of artemether-lumefantrine and artesunate-amodiaquine for the treatment of uncomplicated falciparum malaria in children

Mozambique adopted artemisinin-based combination therapy (ACT) for the treatment of uncomplicated Plasmodium falciparum malaria in the year 2006, and since 2009 artemether-lumefantrine (AL) and artesunate-amodiaquine (ASAQ) have been proposed as alternative first-line treatments.

A review of the effects of artemether-lumefantrine on gametocyte carriage and disease transmission

While significant advances have been made in the prevention and treatment of malaria in recent years, these successes continue to fall short of the World Health Organization (WHO) goals for malaria control and elimination.

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