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Malaria: the king is threatened.


 Malaria received high priority at the XI international Congress for Tropical Medicine held in the fall of 1984. 30 of the sessions focused on the malarial parasite and its "Anopheles" mosquito vector. Topics covered included genetics, epidemiology, chemotherapy, health care delivery, training, and vaccine development. Dr. (Sir) Gustav Nossal, Director of the Walter and Eliza Hall Medical Research Institute, Victoria, Australia, set the theme with his statement: "Vaccines are history's most cost-effective public health tool." He went on to add that the importance of a malaria vaccine is equivalent to that of the Salk vaccine. Some progress has been made towards the development of malaria vaccines. Most advanced is the antisporozoite vaccine being developed by Drs. Ruth and Victor Nussensweig of New York University Medical Hospital and groups at the National Institutes of Health and Walter Reed Army Institute of Research in Washington. In several papers, Dr. Ruth Nussensweig and members of her research team presented biotechnical details of their work that has led to the identification of the main antigen involved in stimulating the body's immune system to produce protective antibodies against sporozoites of "Plasmodium falciparum," the most deadly of the human malarial parasites. Due to the fact that the sporozoite vaccine may not be totally effective, a 2nd vaccine -- a merozoite vaccine -- is being developed. Field testing for this 2nd vaccine most likely will begin in about 2 years. Dr. Geoffrey Targett of the University of London's School of Hygiene and Tropical Medicine reported progress on the development of a 3rd "altruistic" vaccine, which would work against the sexual stage of malaria, transmitted to a mosquito when it feasts on an infected person. Both scientists and health worker participants at the congress were cautious in their assessment of the potential vaccines. No one knows as yet their final properties, e.g., stability, mode of administration, or length of time they will provide immunity. Reports on the geographical distribution of drug resistance showed that chloroquine-resistant "P. falciparum" strains have spread to all continents in the tropics. From Thailand there also were reports of Mefloquine resistance. In discussion, Dr. W. H. Wernsdorfer, Chief of the World Health Organization's Malaria Research Unit, advised that the poorer nations will be hit the hardest if drug resistance is permitted to spread unchecked.
