Far from extinct, disease affects 300 million
Dr. Bart Knols has been called the “rock star of malaria,” a title he chuckles at. But once the Dutch-born expert in insects gets going on the subject of malaria, his eyes light up and he can’t stop talking.
“I’m a medical entymologist – that means I’m passionate about doing something about insects that make you sick,” he told The Media Line. “Malaria is a disease that is still affecting some 300 million people around the world today.”
Knols said that an estimated 655,000 people die each year from malaria – mostly pregnant women and children in sub-Saharan Africa who have a compromised immune system. Knols was in Israel in December for a conference organized by Jerusalem’s Hebrew University School of Public Health.
For Knols, the fight against malaria is personal. He contracted the disease nine times during the eleven years during which he lived in Africa, mostly in Kenya and Tanzania. His wife almost died of malaria.
“A child dying of malaria today is a needless death – we have drugs and prevention tools that work,” he said. “It is a sad story that as a global community we can’t get those drugs to everyone. The only way to go is to try elimination of the disease altogether.”
Malaria was completely eliminated in Israel in the 1940s, thanks to Dr. Israel Kliger, a Russian-born, American-trained infectious disease specialist who put together an integrated program in the 1920s and ‘30s. He drained marshes, including the Hula swamp, which today is a prime bird-migration site, and sprayed areas that were infested with mosquito larvae.
Kliger also conducted an educational program to teach parents how to protect their children against malaria, and to obtain treatment as soon as it was needed.
It is this same integrated approach that Knols, who also chairs the advisory board of the Dutch Malaria Foundation, favors.
“Here in Israel malaria was rampant at the beginning of the last century — people were dying like flies,” Knols said. “People in Israel have forgotten this, but the malaria situation was as intense –or more intense — than in many parts of Africa today.”
Malaria is spread when a mosquito bites someone who is infected with the parasite of malaria, the disease incubates in the mosquito for 10 to 14 days, and then the parasite is transferred to the next host when the mosquito bites someone else. The most common way to fight malaria today is with bed nets treated with insecticide, or by spraying insecticide on walls.”
Over time, though, mosquitoes have become resistant to many of the insecticides. Some researchers are trying to find the mosquitoes carrying the disease and get them before they hatch.
“I am working on new ways to control malaria mosquitoes,” Dr. Silas Majambere, an African researcher from Burundi who is working in Zanzibar told The Media Line. “I’m trying to control mosquitoes at the source, when they are still in the water stage before they fly out and bite people.”
The hardest part, he says, is finding where the mosquito larvae congregate.
“I’m trying to get adult mosquitoes to pick up the larvae themselves and take it with them to the water when they go to lay their eggs,” he said. “In that way, you don’t have to know where the water bodies are – the mosquitoes know better than we do.”
Another option to eliminate malaria is through a vaccine, and millions of dollars have been spent trying to create one. Bart Knols said a vaccine will likely be commercially available within the next two years, but it will only be thirty-percent effective in any case.
Conference organizer Dr. Maureen Malownay of Hebrew University said the forum aimed to take Israel’s experience from the past and use it in the future.
“We are trying to design a program for malaria elimination in areas that are almost there but not quite because that last bit is the hardest part,” she told The Media Line. “Kliger realized that until malaria was conquered in mandate Palestine there could not be settlement in all of those areas. What we learn from him is that to be successful takes determination and drive and an almost militaristic strategy to eliminate the mosquito.”