The Planet

How We’re Stopping Malaria Before It Starts

by James Poulos

December 18, 2017
Rapid detection testing in Mali. Photo via President's Malaria Initiative/Flickr.

How do you prevent a disease that gets harder to treat the more you fight it?

That’s the dilemma malaria researchers have faced for decades. Drugs developed in the middle of the 1900s proved effective — until the disease became resistant. But as malaria came roaring back in the 21st century, doctors and epidemiologists had little choice but to give the old ways a second look.

What they found was a surprising workaround that has rescued millions in West Africa. Because malaria has long been rampant, resistance to classical treatment — so-called “chemoprevention” — has dropped. But to make sure it doesn’t zoom back up again, researchers determined that drugs can be administered effectively only when seasonal rains come and malaria peaks.

The sheer difficulty of administering the drugs, often to children in remote and inaccessible areas, remains high. But the results of a rigorous string of trials conducted since 2000, when over 800,000 were killed by the disease annually, showed so much promise that health workers rose to the occasion.

Right off the top, researchers concluded, rainy-season chemoprevention using ostensibly outdated drugs could, in fact, save 80,000 lives a year. At the same time, they could strike the disease at its root, taking more than 8.5 million cases of illness off the table.

So far, it’s taking time to ramp up results in the real world. In 2015 and 2016, countries that utilize chemoprevention have seen a total decrease in cases of malaria by about 6 million and 40,000 fewer deaths year to year, according to Nature. That’s good enough to pave the way for an expansion of the programs — both in the territory covered and in the mix of traditional drugs used to hit the disease before it can build its resistance back.

With “super malaria” already on the march in Southeast Asia, there’s little time to waste. Advanced gene technology could change the game in the relatively near future by impairing the ability of mosquitoes themselves to carry malaria. But for the children of West Africa, who can’t afford to wait that long, it’s the past that’s bringing new life to the present. 

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How We’re Stopping Malaria Before It Starts