Solve for M: 5 key challenges to ending malaria

In 1897, Dr. Ronald Ross — an Indian-born British surgeon who counted poetry, mathematics and songwriting among his other passions — made a medical discovery that would change the course of history.

Stationed in Secundebad, a monsoon-drenched city in central India, Ross identified the malaria parasite in the gut of a dissected Anopheles mosquito. His discovery confirmed that the winged pest was, in fact, responsible for spreading one of the oldest, deadliest and most devastating diseases on the planet.

Ross was knighted and awarded a Nobel Prize for his efforts and deservedly so — his discovery laid the foundation for the modern fight against malaria.

Historic progress

We’ve made significant strides since Ross’ time. Malaria has been eliminated throughout most of the developed world, including the United States in 1951. And progress is accelerating: Since 2000, we’ve cut global malaria deaths by half, saving 3.3 million lives — most of them children and pregnant women in Africa.

However, the work is far from done. A child still dies every minute from a mosquito bite, and more than 200 million people are afflicted with the disease each year, keeping adults out of work, children out of school and stifling the growth of developing economies.

Based on the progress of the past decade, there’s a growing determination among the global health community to eradicate the disease once and for all, recognizing that the only way to ensure zero malaria deaths is to have zero malaria.

Going on the offense

So what will it take to finish the job?

We need to rethink the malaria problem in as radical a way as Ross did more than a century ago. For all our progress, the prevailing approach to control malaria has fundamentally been about playing defense: trying to prevent mosquitos from biting and treating people when they’re sick so they don’t die. Don’t get me wrong. That has been the most cost-effective way of tackling a complex problem, going after the low-hanging fruit and bringing down the number of cases and deaths dramatically.

But to win this fight, we need to take a “parasite’s eye” view of the problem. We must attack the malaria parasite where it lives — in the human reservoir — with aggressive new approaches to find, clear and prevent onward transmission of malaria, even in asymptomatic carriers of the disease. In short, we must go on offense.

As part of that approach, we need to confront one of the newest and most urgent threats to the advances we’ve made against malaria: resistance in Asia to the front-line treatment of the disease, artemisinin. The last time drug-resistant malaria developed in that part of the world, it spread to India and Africa, robbing us of chloroquine as an effective tool.

If that happens again, it could cost millions of lives, since we are at least four to five years away from developing a viable treatment alternative.

The path forward

We find ourselves at another watershed moment in the malaria fight, and the only way we’re going to succeed is through relentless innovation. We need the next generation of tools and new implementation approaches; we need to harness the power of distinctly modern advances such as the use of mobile phones and big data in health.

Broadly speaking, we’ve identified five key challenges the world needs to solve to win this fight. Every week and a half, starting Monday, we’ll zero in on one challenge and let you know who’s innovating to find solutions. The series will culminate in some big news regarding the malaria community’s plan to reach eradication, delivered by one of the world’s biggest names and most prolific innovators in fighting disease, Bill Gates.

So stay tuned, and join us here this week as we launch with Challenge No. 1: Find the parasite, the first of five topics we’ll be covering in our series.

This article is part of a new series entitled Solve for M: 5 Key Challenges to Ending Malaria, hosted by Devex in partnership Malaria No More and the Bill & Melinda Gates Foundation.

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