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Smart Science Future Of Malaria Eradication 

By Leocadia Bongben In Doha, Qatar

Patients suffering from malaria may, in the future, no longer have to throw their drugs under the bed or stop treatment as smart science could be used in malaria eradication.

Scientists are now able to use engineering and technology to culture parasites -grow them in laboratories and use them to screen millions of molecules. Through this method, they test enzyme systems to mimic what the body is going to do with a drug, in a test tube and decipher what is likely to happen in a human.

Kelly Chibale, Professor of Organic Chemistry and South African National Research Chair in Drug Discovery, in collaboration with Medicines for Malaria Venture, MMV, is working on  Mino Pyridines –  a class of chemicals – to develop a new malaria drug.

The process involves the use of hits – something that gives a possible result in screening; transform this into a lead – something that gives confidence, including the fact that you can infect an animal with a disease and cure it. These move through a value chain until they become medicines compared to a drug made in the clinic.

"Through this method,there is hope we would come up with a single dose anti- malaria drug in the near future", Chibale told journalists during the world conference of Science Journalists at the Qatar Foundation Students Centre in Qatar, Tuesday.

The advantage of the single dose drug is that the chemicals are unique, with chemical structures unrelated to any existing drug. This is important in that the parasite would not have been used to this type of molecule before, coupled with the fact that the molecules work on the strains which are resistant to many of the conventional drugs.

The single dose malaria, predicted to kill, within 72 hours, the malaria parasite rapidly and effectively, would be a solution to relapses in patients and resistance. Presently, artemisinin combination therapy, ACT, and other malaria drugs used today, have long treatment duration of more than three days.  When the patients feel a bit better, they stop treatment and, in the process, develop resistance.

Though ACTs introduced in 2009 were perceived to be more effective than Chloroquine and other malaria drugs used then, the challenge is for experts to come up with another drug when the ACTS equally prove to be less effective, presently given in multiple dose.

The confidence experts have in the single dose drug stems from the available data that the molecule is active on strains which are resistant in the available drugs.  And through data, the dose predicted in human is very much lower and thus more effective.  The study carried out with this class of molecule has provided insight on enzymes responsible for metabolising drugs, that is, converting the drug into a form that allows it to be expelled.

With the ongoing research, one important thing about malaria eradication, Chibale says, is to go beyond treating the blood stage of the disease – when there are symptoms; to the second stage – when the parasite feeds on the infected person to complete its life cycle and when the parasite is at the larvae stage and there are no symptoms. The challenge, however, is to have a drug that can kill the parasite without harming other parts, says Chibale.

Abanda Ngu, Press Officer of the Cameroon Biotechnology Centre, delegate at the conference, said the single dose drug would be a positive step in the roll back malaria initiative. The long treatment becomes boring and once the patients feel better, they stop taking the drugs, he said.
It is for this reason that Timothy N.C. Wells, Chief Scientist Officer of MMV, says the future of malaria eradication lies in new medicines to fill the gaps and treat vulnerable groups such as women and children.

But, this does not mean downplaying the need for vaccines. With eminent launch of a malaria vaccine in 2015, Wells’ worry is that the vaccine is only 50 percent effective. Malaria eradication has to be collective action. The example of the collaboration between South Africa and MMV is one but many more need to be developed.

To Chibale, government needs to invest more in traditional medicine as is already the case in South Africa where interaction and discussion have been facilitated between the latter and conventional medicines. Through such collaboration, both would understand the effects of traditional medicine on conventional drugs and vice versa.

Though in Cameroon some traditional healers have registered their drugs and screened their drugs for toxicity at the Ministry of Scientific Research, they have been clamouring for the creation of training centers for traditional healers. 

If more investment is directed towards traditional medicine, the active elements in drugs would be extracted and used in the search for a malaria drug. Chibale expressed the worry that traditional drugs lack safety information and governments should fund research in safety and toxicity of traditional medicines.

However, having a single dose drug is one thing and access and availability to patients, especially in remote areas, is the challenge that lies in the way of malaria eradication, says Jaya Banerji, Advocacy and Communication Director at MMV. The challenge of stock outs is always lingering as government finds it difficult to afford drugs and relies on donors who, at times, decide where to supply their drugs.

Abanda attributes stock outs in some countries like Cameroon to a situation, whereby, drugs are subsidised in some countries and not in all countries of the region, they are siphoned and sold at a much higher price in other countries.

The use of the mobile phone to track stocks providing information on availability to the central data base, experimented by Tanzania to check stock outs, is an example Cameroon and other countries in the region should emulate, he suggests.

In view of the issues surrounding malaria, experts have concluded that malaria needs a multifaceted approach starting from prevention, diagnosis, the use of treated mosquito nets, vaccines and drugs and the combined efforts of government and the communities.

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