The malaria vaccine is continuing good news in the battle against disease in Africa, but it’s not a cause for great celebration. I’m a bit peeved, in fact, with the PR-rollout of Mosquirix by GlaxoSmithKline which strikes me more as an attempt by the pharma to remain relevant after the failure of its Sanofi–GSK Covid vaccine.

Here’s the thing. Mosquirix has been around in some form since 1987. Much improved, its efficacy is still as low as 26% (the highest in any study was 50%) and only for toddlers. It’s not effective against young adults and older.
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Should You Go?

Should You Go?

What’s the greatest risk to an international traveler right now? Obviously, Covid, but NOT for the reason you think! A vaccinated traveler is very unlikely to get sick from Covid. More vaccinated travelers are going to get hurt and some die from slipping on the stairs of the jetway than from Covid. More vaccinated travelers headed into wild jungles (who are taking malaria pills) will still get sick from malaria than from Covid.

The Covid vaccine is as much a game changer as Delta. Its efficacy is better than all the vaccines before it, better than malaria pills, better than attending daily mass, better than practically anything! So what’s the problem?
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Corona Chloroquine

Corona Chloroquine

I know something about chloroquine. It was the reason I first got malaria.

It’s also the reason I’ve lost about 50% of the vision in my right eye. I listen with malaria shivers to a TV president espousing chloroquine as our vial of hope, and I’ve come to realize that it isn’t just evil that’s destroying our world, today. It’s also hope.

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World Poverty Day

World Poverty Day

worldpovertydayToday is the World’s Poor Day. Oh, sorry, I mean World Malaria Day.

There’s nothing – no war, no geopolitical area, no language, no country club, no store or slum or club or crime gathering of persons that so starkly defines poverty as malaria. It’s easily cured and if cured often and widely enough, it’s effectively controlled. That’s why so much attention is given it: it’s something easily done, which isn’t.

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What if we end Malaria?

What if we end Malaria?

toobigtosucceedThe fight against malaria is going well, but American attitudes will have to change to achieve ultimate success.

Malaria threatens much of the world because there’s no vaccine and its threat increases proportionately with poverty.

But a successful vaccine or other efforts like bednets could actually increase poverty and disease overall.

Malaria was eradicated in most of the western world when sanitation and potable water became government responsibilities. Sanitation and the delivery of potable water reflect less poverty.

Less trash and better managed water reduces mosquitos, which transmit malaria.

The circular relationships of water and trash to malaria means that malaria will be automatically reduced – even eradicated – when better water and trash collection arrive poor communities.

A critical part of the Obama administration’s initiative to reduce malaria understands this, but it is somewhat buried in its presentation to Congress in order to avoid the expected criticism that there is too much government in such initiatives:

“The President’s Malaria Initiative (PMI) works to reduce the burden of malaria while at the same time strengthening host country health systems and workforces,” in my estimation is the key ingredient, but you have to read quite deeply into the report to get to this section. The front of the report is all about nets, spraying and diagnosing, things that Congresspersons can grasp.

“You can’t fight malaria without health care workers,” the somewhat buried part of the President’s plan understands well, because these workers don’t simply instruct people on how to fight malaria, they work on social services like potable water and trash collection.

The American Congress – indeed, the American people – don’t accept the huge efforts required by government to build social institutions like public sanitation. Whenever such efforts are suggested, naysayers point to corruption and lack of private enterprise involvement.

That’s why efforts like the President’s Malaria Initiative have to fool Congress into thinking that American money is not being spent on such grand goals, but on things like nets and spray.

In America all criticism of large scale government involvement finally devolves to the insane belief that government is the problem, not the solution, and this mantra has been insidiously instilled in the American psyche ever since President Reagan said it nearly 35 years ago.

The largest private organization fighting malaria is the Bill & Melinda Gates Foundation. While their efforts are noble, they haven’t achieved a fraction of what government-to-government aid, like the President’s Initiative, has:

Two researchers at Duke University recently concluded that “impressive progress in the fight against malaria” occurs exactly because of a “substantial increase in [government-to-government] funding,” specifically the President’s Initiative.

Private NGOs focus on possible cures like vaccines and inexpensive solutions like bednets because it’s a lot cheaper than developing public health systems.

Yet as they approach success a horrible catastrophe looms: What if the Bill Gates Foundation finds a malaria vaccine? What if enough bednets are distributed to basically reduce malaria substantially?

Many more children will live. And so without improved public health systems many more children will also die. A host of other diseases are on an alarming increase in Africa, like a huge range of gastro-intestinal diarrheas and tuberculosis.

Without delivery of potable water, none of these “children saved from malaria” will be healthy. So while malaria might be reduced substantially, overall public health will decline.

It’s simply a matter of money. Government-to-government aid for reducing malaria last year was $3 billion. Private NGO totals, including the Gates Foundation, was less than half that.

The Duke researchers suggest that $6 billion annually is necessary.

Six billion isn’t very much in western world budgets, but unless it’s used to buy bednets or underwrite specific vaccine developments, legislatures like the American Congress refuse to act, ignoring grander goals like developing public health systems.

Yet that was exactly how malaria was eradicated from the U.S.!

Until the attitude promulgated in America that government is less effective than private initiative changes, the world will not.

New Yellow Fever Research

New Yellow Fever Research

220px-Aedes_aegypti_bloodfeeding_CDC_GathanyNew research on yellow fever could lead to improved vaccines and quick cures.

Yellow fever is a mosquito born disease that is found throughout South America and sub-Saharan Africa. While the disease is actually more deadly than malaria, it has never been as widely a threat.

In part this is because the first stages are not as severe as malaria’s and it’s usually the secondary effects that lead to mortality. These secondary effects can be quite prolonged. As a result it’s possible that many deaths in sub-Saharan Africa are actually from a yellow fever infection while being diagnosed as something else.

Mostly, however, it’s because persons who recover from the disease acquire virtually complete immunity. This is completely unlike malaria. Persons can succomb to malaria multiple times and likely achieve no immunity against a future infection.

The new research is one of the first in-depth studies that carefully looks at how the disease works. It’s complicated and fascinating. Note that the research was done on macaques, although scientists are fairly confident that the dynamics would be the same in all primates.

The virus switches on and switches off a variety of genes while it resides in the liver.

Over time this leads to a variety of pathological events, including liver and other organ failure.

In the past in Africa mosquito-born diseases like malaria and yellow fever were thought to manifest mortality more quickly and more simply.

As most travelers know there is an effective yellow fever vaccine, although it loses significant effectiveness for very young children and older adults. Persons who obtain the inoculation in their young adult years are easily revaccinated every ten years for extremely good protection.

But the vaccine is expensive and has been difficult to disseminate throughout endemic areas. It is a fragile vaccine that requires refrigeration and is a live-virus based vaccine, which means that incorrect storage or administration can actually give the patient the disease rather than the protection.

By studying the genetic trail of the disease’s manifestations, scientists may be able to interrupt organ damage by neutralizing the proteins that switch certain genes on or off.

Travelers to East Africa are particularly sensitive to not just the pathology but the politics of the disease.

Because vaccination throughout sub-Saharan Africa combined with natural immunity has minimized the disease’s effects over the last half century, many areas of sub-Saharan Africa which have not experienced any yellow fever whatever are particularly susceptible should an outbreak occur.

Tanzania, especially, has reacted to yellow fever outbreaks in neighboring countries like Uganda and The Congo by suddenly – without very much if any notice – requiring incoming visitors to have the inoculation … even though Tanzania itself is yellow fever free.

This has put it from time to time at odds with national health authorities like the CDC that recommend against obtaining the vaccination except for visits to countries that actually have disease outbreaks.

Many other countries in Africa, such as South Africa, require evidence of the vaccination if the traveler has been in an effected country within the last six months.

Genetic science is advancing so quickly that doctors are discovering methods of interruption or curing of diseases that before were thought only capable of being prevented with a vaccine, and that may the route of current science towards the management of this curious and powerful disease.

Gates Gets Gross

Gates Gets Gross

gatesinafricaBill Gates is a very nice man captured in the last century, and his remarkable generosity grossly misses the mark.

The Melinda & Bill Gates Foundation just released Bill Gates’ “annual letter.” The Foundation continues to seek solutions to two of Africa’s crises, malaria and poverty.

The two, of course, are interconnected. Throughout the world the level of malaria infection is inversely proportional to personal income. I don’t think, though, that this fact drove the Gates Foundation’s mission development.

Gates and most of the world charities tackle problems as crises to the exclusion of remedying the fundamentals.

Don’t get me wrong. It isn’t as if these generous folks make crises out of situations in order to be good philanthropists. Malaria on an individual level is a distinct crisis. Hunger caused by extreme poverty has an immediate simple remedy when dealt with as a crisis: dinner.

But the problem with Gates and most of the world’s charities is that despite how rich they may be, they aren’t rich enough to tackle the fundamentals, and so they default to actions that deal with incidental crises.

Malaria is the perfect example.

Malaria was eradicated from most of the developing world without drugs or bednets. My own Chicago’s Fullerton marsh was a cesspool of malaria right until the great fire of the 1860s.

After the fire and a growing awareness that government had to step up, malaria was systematically eradicated from Chicago by an exponential increase in public expenditures that started with increased urban hygiene (better sewers and drainage) and radical use of crude oil to suffocate marshes.

Even at that time suffocating marshes was an ecological controversy, but the power of the public domain was much greater then than now. The majority ruled.

By the early 20th century, there was no malaria in Chicago. An early NIH study of the eradication found a number of additional socially progressive policies kept malaria from returning to large urban areas like Chicago, such as banning child labor.

By the 1930s malaria in the U.S. was confined to 13 poor, southeastern states that did not have the tax base to successfully eradicate the disease. So government came to the rescue.

The 1947 National Malaria Eradication campaign moved money from the rich industrialized northeast to eradicate malaria in the south, and was successful in doing so in less than a decade.

I suspect similar stories exist throughout the developed world. And the solutions employed then would work today in Kenya or Indonesia. But destruction of the environment (oiling marshes and later, using DDT) is no longer considered a tit-for-tat that might balance in the long run, and modernizing Nairobi’s sewage system is too expensive for even the Gates Foundation.

That example is a bit oversimplified, since in fact the Gates Foundation probably does have both the capital and wherewithal to modernize (at least once) the Nairobi sewage system. What I really mean, of course, is to effect a modernization and cleanliness that like in late 19th century Chicago was achieved by modernization of a public service.

Today Nairobi is exponentially bigger than Chicago was in 1860, and Nairobi is affected physiologically by what happens in Mombasa, Addis, Kampala and Dar, so fixing Nairobi without simultaneously fixing those other great metropolises would be problematic with regards to eradicating malaria.

BUT (and this is a very big but) so is the world’s wealth exponentially bigger today than in 1860, and that’s the point.

Were the public interest as dominant today as it was in Chicago in 1860, Nairobi, Mombasa, Addis, Kampala and Dar would be free of malaria, because the rich world would have fixed their sewer systems… (and of course, a lot more).

What has changed in the last 150 years is a disproportional amount of wealth has become concentrated among a few afraid it will be taken from them. There are not enough people in that pool of the paranoid very wealthy for any truly democratic or benevolent change to take place.

That isn’t to say that a majority of rich people, among which I’m sure Bill Gates is one, are not generous and intelligent enough to ante up. In this year’s letter, Gates castigates Americans for their paltry $30 annually that the U.S. provides in world aid.

But the power brokers within that pool are not the Gates of the world. They’re the Koch’s of the world. And the Koch’s rule. So long as there are Koch’s there will not be more than $30 annually per American spent on world aid.

So what’s left?

Gates. Deal with a problem as a crisis and not a fundamental, and that’s precisely what’s happened with malaria.

In October the huge multinational pharmaceutical Glaxonsmithkline (GSK) announced it would market the world’s first malaria vaccine.

The vaccine is about 60% efficacious. Not bad but incapable of eradicating malaria. It took about 30 years and billions of dollars to develop this. The beneficiaries are not exclusively people saved from malaria. It will probably in equal measure make the rich, richer.

(Note this cynical observation: If there were a vaccine that could eradicate malaria, that could be a big downer for the investors who paid to develop the vaccine.)

When the world won’t step up, when your own government or township won’t tax enough to fix fundamental problems, we have no choice: Gates and GSK become our only hope and it’s a very momentary, transitory solution that’s provided: a stop-gap.

And the powerful in the pool of the wealthy then distort those efforts to suggest they are successful in terms that claim governments can’t be.

And the cycle of mythology is perpetuated. Gates recognizes this. His annual letter is built on a series of “myths.”

I prefer a Warren Buffet to a Bill Gates. Frankly, I don’t prefer either of them in theory. There should not be super rich.

But Buffet often focuses on the fundamentals. Gates is an engineer. Or as a brilliant Dutch satirist pointed out this week, Gates treats aid like he treats Microsoft: self-perpetuating and growing and never completely tackling the problem holistically.

See Ikenna’s video below:

Code 8 To The Rescue!

Code 8 To The Rescue!

TeamCode8Risking at least irony four male university students in Kampala just won the inaugural Women’s Empowerment Award in St. Petersburg for an innovative device to easily and rapidly detect malaria.

Any notion that’s it more than ironic is lost immediately when you realize that pregnant mothers in Africa harbor a greater fear of having malaria than any other group.

This is not only because malaria can quickly end a pregnancy but because the treatment can harm the fetus and in cases where the mother is less than perfectly healthy, cause miscarriage.

The four Makere university students engineered the device which is plugged into a smartphone, and created the app software that analyzes it.

The best test for malaria is a blood test. But the test will often come back negative when in fact the patient has malaria. What? This is because the best symptom of malaria is altered red blood cells, which explode in the body during a malaria attack but then are methodically excreted. A malaria attack rarely lasts longer than an hour, but the interval before the next attack can be as long as twelve hours.

So by the time the patient gets to the clinic and waits for her test, her symptoms may have subsided. And since reading the microscopic results of a swab is a human endeavor, mistakes happen and more often when the sensitivity of a pregnant mother is considered.

My wife suffered the same incorrect diagnosis here in the U.S. after returning from a safari and contracting malaria.

We called our doctor while she was having the attack; we knew it was malaria. But by the time she felt good enough to get in the car (after the attack subsides), travel to the hospital, wait for the test, 3-4 hours had transpired and the diagnosis she received was negative.

(Aggressive protestations sufficed for us to get the right therapy, and she was cured, and a subsequent visit with a test closer to a subsequent attack before the medication began to take hold proved we were correct: she had malaria.)

The four Uganda computer science students created a simple red-light device which they call a “matiscope.” Similar, in fact, to the types of devices that read fingerprints, the red light sensor detects red blood cells without any skin piercing.

Blood cells ooze to the surface of the skin normally all the time, but are so few they aren’t noticeable. And the skin itself is porous. The light penetrates several micro layers reaching even more red blood cells.

The sensor detects a blood cell altered by a malaria attack instantly.

The four students were guests of Microsoft for the company’s annual “Imagine Cup” competition for students, this year held in St. Petersburg. While there they won the inaugural Women’s Empowerment Award organized by an UN agency.

Brian Gitta, Joshua Businge, Simon Lubambo and Josiah Kavuma call themselves “Team Code 8″ after laboring through eight different computer code designs before hitting on the one that worked.

Team leader, Gitta, told an audience he was motivated to invent the device because of his “fear of needles” and being “pricked to death” as a child who constantly contracted malaria.

But, in fact, simply reducing the time between the attack and detection is the genius of the invention. And Team Code 8’s matiscope and the software they developed to detect the altered red blood cells isn’t sophisticated enough yet to determine the specific type of malaria (there are four types) or exactly how bad the infection is, often necessary for determining proper treatment.

So it’s a first but very important step, and for millions of people who might be infected, it might be all that’s needed. Normally otherwise healthy adults who contract malaria can be prescribed rather standard levels of medication to wipe it out, without knowing specifically the malaria type or level of infection.

What it means for pregnant mothers, though, is that the doctors have to hospitalize the mother and make sure that the blood test is taken immediately as the next attack begins.

The practicality of the device, though, allows for self diagnoses very much as similar devices are being manufactured today for pregnancy and HIV AIDS.

The app for the smartphone, of course, is cheap. But right now the plug-in device is fairly cost prohibitive for most individual rural Africans, but could prove cost beneficial for remote health clinics, companies and institutions which provide on-site medical care, and of course, hospitals.

But the Team is contacting entrepreneurs around the world who with mass production could greatly reduce the cost.

Leave it to the kids, eh?

Hail to the Victor Valient

Hail to the Victor Valient

goodgovtWe’re getting oh so close to both a vaccine and simple cure for malaria! And both the journey and the ultimate victory will confirm that only governments, not charity or private enterprise, are capable of attaining such success.

Last week the National Institutes of Health (NIH) announced that it had successfully completed preliminary trials of PfSPZ, what it still calls an “investigational” malaria vaccine that was found to be “safe, generate an immune system response, and to offer protection against malaria infection in healthy adults.”

The discovery was published in the August 8 journal, Science.

This isn’t quite New York Times front page material just yet, because the study group of 57 adults between 18 and 45 years old was very small and localized, and the vaccine success depends upon large intravenous injections. But the result was 100% protection, which is unheard of in such early trials.

This comes on the heels of the discovery of another drug a few months ago that is a simple preventative and cure, which I wrote about in an earlier blog.

AND that was announced just before Africa’s first-ever drug was discovered to cure malaria by an institute associated with the University of Cape Town: “MMV390048″ is awaiting a common name but is a completely innovative malaria drug attacking the parasite at the blood stage.

The key ingredient in these three major break-through discoveries is … government funding. The latter two breakthroughs had private help (the Switzerland-based Medicines for Malaria, and the Gates Foundation.) But in both cases it’s likely they would have been developed without this private help.

But the most important discovery, the vaccine, is strictly a collaboration of three U.S. government institutions: the National Institute of Allergy and Infectious Diseases (NIAID), the Walter Reed Army Institute of Research, Silver Spring, Md., and the Naval Medical Research Center, Bethesda, Md.

I have grown increasingly skeptical over the years of private charity in Africa, and more widely, in general. There is no question that the battle to defeat malaria has benefited enormously from private charity, and specifically from the Gates Foundation.

Just as there’s been a lot of very good charity in all avenues of life throughout Africa with many successes.

But when push comes to shove not even Bill Gates’ billions is enough. Precisely because billions is not always the answer, but rather as shown by PfSPZ, years and years of expertise and experience from a variety of large government research institutions that work together.

Actually, that’s the key to the key: working together. Well meaning charity groups tend to be provincial and often secretive of their research, and I know this is particularly true of wildlife and conservation groups within Africa.

And it’s intrinsically true of private enterprise: Glaxo Smith Kline is probably the pharmaceutical that has spent the most money on malaria research. In 2009 they announced their best success yet, a vaccine that has proved about 30% effective in babies aged five to 17 months.

That’s nothing compared to the above three break-throughs.

At this point in the malaria battle it’s almost impossible to claim that any one group, including the government, has any total monopoly on research and development:

The battle against malaria has been energetically pursued by private enterprise and charity for my entire life in Africa, and before that and since the earliest development in colonial Africa, by government agencies.

So the body of research and experience regarding malaria is huge and very intermingled. Still, as demonstrated this week by the U.S. government health institutes, ultimately it is only massive and massively interconnected government agencies which can achieve the ultimate breakthrough.

And this is no less true of the battle against malaria than the battle against poverty or illiteracy or any social problem. And what’s more, when private success is achieved, it’s often only after much earlier public involvement.

Breakthrough drugs in general is the perfect example. Most drugs’ history begins in government funded public institutions, like university labs.

The irony, of course, is that Glaxo Smith Kline will likely be the principal commercial benefactor of the U.S. discovered malaria cure, as our archaic system won’t allow the U.S. government to manufacture and distribute the drug (except to our troops and civil servants).

Which, of course, is wrong. The drug would then be cheaper, and any profits could be plowed into something else … like say education or housing, instead of acid reflux disorder.

What we are learning in this fascinating journey towards eradicating malaria isn’t that there might not be a place for personal initiative or enterprise, but that the world is too large, complicated and interconnected today to achieve real social success except when governments work well.

And true, many, many don’t. But when on balance they do, like our own United States of America’s institutes of health, then yes, Virginia, happiness can be achieved.

Malaria Attacks Sequestration

Malaria Attacks Sequestration

Dr. Michael Riscoe
An exciting breakthrough may have created a new generation of effective, cheap and long-lasting malaria medicine for both curing and preventing the disease.

The breakthrough is exciting, because it came from out of the blue. We’ve been watching a number of malaria medicines and other strategies develop over the last several years, and this was not on the watch list.

It wasn’t on the watch list, because it comes remarkably from a not-for-profit, the Switzerland-based Medicines for Malaria and not from one of the world’s major pharmaceuticals, all of which have been working feverishly on achieving results that the creators of this drug believe they have accomplished.

Neither the Gates foundations or WHO or other major malaria fighting organizations were involved. It was the small Swiss not-for-profit, America’s National Institute of Health, an experimental lab at the Oregon Health & Science University and the Portland VA Medical Center.

These are not your normal worldwide players in major drugs. And kudus to them! These are … to put it mildly … social government institutions hurting from sequestration! They are examples of why government is necessary, and big government can be good government.

“We believe ELQ-300 has a chance to change the landscape of how we fight malaria across the world,” said Michael Riscoe, Ph.D., principal investigator in the research, a professor of molecular microbiology and immunology at OHSU and director of the Experimental Chemotherapy Lab at the Portland VA Medical Center.

Malaria is a highly complex disease with nine distinct stages, four in the mosquito and five in the victim, us. Virtually all previous drugs targeted one stage to disrupt the advance of the disease.

As published in the March 20 issue of Science of Translational Medicine ELQ-300 (or “Quinolone” as it’s likely to be called) targets multiple stages, finds the parasite long before other medicines detect it, can be used for both treatment and prevention with a single dose, and is inexpensive.

March 20? More than two months ago?

I can’t figure out why this news took so long to surface. The scientific report came out in late March, but worldwide media did not pick it up until last week.

When giant foundations and major multinational pharmaceuticals are involved, it can tempt one into all sorts of conspiracy theories. One wonders, for example, which multinational pharmaceutical will ultimately manufacture the drug and under what conditions.

But we may be jumping the gun. Human trials in Africa are only beginning.

But of all the malaria news I peruse, this looks extremely promising.

Good News From Africa

Good News From Africa

Four of my most important stories for 2012 were basically great, good news! Exciting discoveries in science in Africa, growing strategies for peace in Africa’s troubled regions, and my having guided an old friend and client, the Don of American zoo directors, Les Fisher!

These are my 6th to 10th Top Ten Stories. To see a list of all The Top Ten, click here.

#7 : China Partners with U.S. for Peace in Sudan
The world’s two most diametrically opposed societies have struggled uncomfortably ever since shaking hands during the Nixon administration in the 1970s. Whether it be over world wars and conflicts, climate change, human rights – you name it, we’ve been at odds.

But this year the two adversaries teamed up to make peace in The Sudan. This is terribly exciting.

Two years ago South Sudan became its own nation after years of civil war with The North. That in itself was amazing, and in no large part because of enormous initiatives by the Obama administration.

But the border between the two has never been completely demarcated. And it goes right through the most productive oil fields in the area, and so border disputes spilled over into outright warfare.

China and the U.S. got together and stopped it. Period.

It is an amazing geopolitical development, because the U.S. is heavily invested in The South, and China, in The North. But rather than parry their positions, they negotiated them for peace.

Unfortunately, trouble persists in both countries not due to this grander conflict. Darfur remains troubling for The North and The South’s northwest states are close to open rebellion.

But the grand deal signed earlier this year between the two hostile siblings of the once singular Sudan state remains laudable.

#8 : Breakthrough Discovery for Malaria Eradication
The devil is in the details to be sure, and despite a generation of unprecedented research and global aid, malaria finds ways to evade suppression. But this year a new genetic discovery might finally herald a definitive way to eradicate this disease that is so devastating in Africa.

Malaria is such a tough candidate for making a vaccine against because it’s really seven different types of life forms. True, it’s only one of the stages that infects us, but that one has proved terribly difficult to fight against.

If we could simply interrupt the change of life forms from one to the other, we’d do the trick. And now, a new genetic discovery gives us a guide towards finding out how to do that. It’s complicated, but perhaps the most promising new science regarding malaria in my life time!

#9 : African Arms Dealer Finally Prosecuted in U.S.
It’s no secret that you can’t fight a war without a gun. But the west – and especially the U.S. – and Russia have suppressed this evident fact because their war machine economies are so important to their overall economies.

And what’s even more embarrassing is that several of the most prominent arms dealers have lived as foreign visitors on extended friendly visas for some time in the U.S. The presumption has to be that the U.S. felt some advantage for letting them stay here.

So it was striking that finally the Obama administration actually began to prosecute arms dealers in a way past administrations, including back through Clinton and Reagan, declined to do.

Viktor Bout, a Russian, was convicted after a full court press by the Obama administration, suggesting more such prosecutions are on the way. This is an African story, because that was the turf on which Bout played, heavily involved in the most recent wars in Liberia and Sierra Leone.

#10 : Les Fisher Goes on Safari at 91 years old
The Don of African Zoo Directors who helped pioneer some of the first American adventure travel in Africa took a group of small friends on a not-so-easy safari into Botswana in the hot season.

I’ve guided Dr. Les Fisher on at least a dozen safaris over the years, and we’ve been in some of the most remote parts of Africa, together.

As I recall this was his 5th “Last Safari Ever!” At 91 that’s hard to argue, but it was hard to argue at 90, too!

Stay tuned.

Malaria Milestone

Malaria Milestone

The greatest of evolutionary battles is between man and his diseases and a recent genetic discovery about malaria gives man a new flank to attack.

Malaria is one of the most intriguing diseases in the world, incredibly complex. It is among the greatest killers in Africa, vying every year as the greatest killer with AIDS and gastrointestinal infections.

Last month researchers at the Centre International de Recherches Médicales de Franceville in Gabon collaborating with French laboratories published an amazing discovery about the genetic makeup of malaria. Their findings could open up an entirely new front for the attack against the disease.

As we learned this past week in Texas, the might of the developed world’s mastery of pesticides has kept malaria and other mosquito born diseases mostly at bay.

Malaria was essentially eradicated from the U.S. by the middle of the last century through extensive use of DDT. Many in the developing world argue for the use of DDT right now in Africa, but control of the substance remains with the developed world that has decided it’s too toxic a pesticide.

That debate is furious but there is strong evidence to suggest DDT might do more harm than good for two very interrelated reasons.

The first is that systematic spraying of the sort that occurred in the U.S. would be too hard to implement in Africa’s most malarial areas, which include sprawling slums and extraordinarily remote wetlands and swamps.

DDT’s toxicity isn’t in dispute: Numerous species of bird, insect and even plants could be eradicated if used. But in light of the terrible plight the sickness strikes every moment in Africa, the world might be willing to lose a few species of bird, insects and plants, but not if the implementation plan is as uncertain as it seems it would be.

Particularly if other remedies for malaria can be found.

Malaria isn’t just a single thing. It seven different life forms, like caterpillars and cocooned pupas and butterflies, but more than double that butterfly formation. The one form that does us damage is the sporozoite which produces the malaria attack.

But all other six forms have to produce and cycle to produce the sporozoite, and just that amazing transformation in an evolutionary sense is absolutely mind-boggling.

Remember, evolution is chance. Imagine the billions, trillions, godzillions of chance mutations that occured on each of the seven life forms meaning we have a permutation of godzillion to the seventh power (which I think is still godzillion).

Anyway, I hope you catch my drift. This is an amazing evolutionary development arguably as complex as many of the most complex life forms on earth, today.

But consider this after you catch your breath. Each life form’s mutated chance change produced some type of response in the disease’s host. Maybe, like sickle cell anemia, the sporozoites slides off the red blood cell so can’t infect it. Maybe another godzillion defenses (many like sickle cell anemia aren’t ideal) occur.

So there is this back-and-forth over time of the disease and its host (including man) trading punches. To date, malaria has won.

We know that apes and chimps get malaria, too. But we didn’t think until this new research that anything other than creatures in man’s family tree got malaria.

Wrong. The new research reveals that the greater spot-nosed monkey gets malaria. The guy is a primate, but we know from DNA research that he is far away from the line of primates that produced chimps, apes and man.

That means that malaria was doing its dirty work before the homonids line evolved from earlier primate forms. And that means that the malaria had to have evolved in some type of parallel way to homonids, and separately, to the greater spot-nosed monkey.

And that means if we can study the detailed difference between greater spot-nosed monkey’s malaria, and hominin’s (man’s), then we might find the point in the complicated life cycle of the disease that is most vulnerable to attack, the spot that makes human malaria distinctly human.

Perhaps it’s a gene in the human malaria that binds to hemoglobin. We’d have never known to look for that gene (among untold numbers of genes) if it wasn’t pointed out to us because it doesn’t exist in the monkey malaria. It’s very likely that that unique gene is of critical importance to the whole malarial chain of events that we might then be able to interrupt.

Go ahead and scratch your head. Read this wonderful summary about malaria that is better than mine. And then, think about it. It’s incredibly fascinating.

Yeh for the Apicoplast!

Yeh for the Apicoplast!

Go get ‘um DeRisi. And Yeh upstages the NFL season opener with an end-run over the Apicoplast! Yes! The battle against malaria, the first offense that might just actually win, has begun!

Here it is, are you ready?

“Chemical Rescue of Malaria Parasites Lacking an Apicoplast Defines Organelle Function in Blood-Stage Plasmodium falciparum

For those of you who think you might have a scintilla of a chance of understanding this, it would behoove you to go to the Home Page of “PLOS” in which this article appears.

This is such an incredibly important scientific breakthrough, that this normally complex scientific journal has rearranged its home page since publication yesterday to try to help us lay folk understand.

So will I try, too.

Malaria is the worst parasitic disease of humans today, and as far as we know, has existed for the longest time of any large scale endemic human parasitic disease.

Its effects are devastating. It’s a story of one organism, the malaria parasite, beating up another, human beings.

My own involvement with malaria has been intense. I know I’ve had it twice, once near death, but I’ve probably had it more often than that. My wife was very sick with it once. Early, bad medications helped partially ruin the sight in my right eye.

I’ve held babies in Africa dying of malaria. I’ve had countless employees sick with it.

Probably every single employee manager for me in Africa has had a close relative, like a child, die of malaria.

I’ve had a dozen or so clients who came home with it from safari and were misdiagnosed and then mistreated. I’ve had more clients who seemed to go crazy when using incorrect malarial prophylactics.

Malaria has beaten us up.

I would love to live to see the day when the fight turns. And it may actually happen!

I’m no scientist and most of my understanding comes not from PLOS’ wonderful attempt at a plebian home page, but from the even simpler attempts at explanation.

The best I’ve found comes from the researchers’ own university, Stanford.

It all has to do with the apicoplast!

Well, that’s it, then!

Sort of. Over the last decade, it was discovered that when the malaria is actually in the human blood stream, it swims merrily around with a little “organelle” inside it called an apicoplast. Organelles are sort of like adopted organs of a single-cell organism that were somehow taken from some other single-cell organism.

A long, long time ago. Apparently this happened millions and millions of years ago. We know this from the genetic structure of malaria. As man was increasing his brain size and creating tools to conquer the planet, the joker malaria was searching madly for a better offense.

Somewhere out there, it found an apicoplast and consumed it into itself forever and that was apparently when it became deadly to man.

But we didn’t know why. For the last decade a number of researchers have been trying to create drugs that would specifically target the apicoplast like a nano drone, but to no avail.

We know there have been dozens of drugs starting with quinine that work for a time against malaria. But the parasite, like most diseases, reproduces so quickly that it’s always just a matter of time until natural selection filters out the progeny resistant to the drug, and then the drug becomes useless.

That’s how I got my first case of malaria. We didn’t know it at the time, but the so-called preventative drug was no longer preventative.

But if we could find a drug that specifically targeted the apicoplast? Whoa. That’s like trying to fashion a bullet that doesn’t just hit the bull’s eye, but the right milliquadrant molecule of the bull’s eye.

Struck out on that one.

Alas, genetic research to the rescue. Why not bioengineer a malaria parasite without an apicoplast? They did. But so what?

You can’t exactly go around the world and replace every malaria parasite that’s in someone’s liver with a bioengineered non-apicoplastic parasite and suddenly make them better.

And you’d have to bioengineer your malaria non-apicoplastic guy to be stronger and better than his original cousin, so he could eventually prevail over his weaker apicoplastic cousin.

Oops. Maybe then you’d create a super malaria parasite that with all its history of clever evolution might something else terribly do.

What Ellen Reh and Joseph DeRisi of Stanford did was study exactly what the apicoplast does for our little malaria parasite. And this is the discovery that will get them the Noble Prize.

It creates a single chemical, IPP for short, that is essential to the parasite. Without IPP, the parasite dies.

So what good is that? You can’t go all around the world with microsyringes and remove the IPP from every malevolent little parasite, can you?

No, of course not. But guess what? This IPP doesn’t only keep the parasite alive, it’s also the arsenal that attacks man.

Now a little secondary lesson on vaccines. You know the difference between “live vaccines” and “dead vaccines” and how the live polio vaccine wasn’t such a good idea in the 1950s.

Nor would a live malaria vaccine be any better. Although scientists have tried very hard, no vaccine they’ve produced works quickly enough that the body develops a defense against it before the vaccine prevails and makes the body sick.

So if we engineer millions and billions of malaria parasites without their apicoplast (which Yeh and DeRisi have already done), and though they die remain organic and whole long enough that our body would recognize them as the devils they once were….

Yes, the way a dead vaccine works. The human body then miraculously engineers all these micro molecular weapons that stay in the body long after the freak bioengineered dead non-apicoplastic malaria that provoked the human arsenal has been discarded.

So … that … maybe, when a real apicoplastic malaria sneaks in.. And it doesn’t look all that different from its freak dead cousin that was there a while ago … well, maybe, then: