A look at one of Africa’s greatest threats

A Minnesota organization receives $1.5 million to fund programs fighting malaria.

Devin Henry

When psychology senior Jane Berezovsky traveled to Kenya in July, it was obvious to her that malaria is a major problem in African countries.

“I lived in a rural area there and they had a lot of issues with children getting malaria,” she said.

Berezovsky said she also noticed there was a lack of resources for protecting against malaria.

The group she traveled with had mosquito nets to use, but many of the local children didn’t, she said.

“It’s expensive for the kids to get them, especially in the orphanages,” she said. “They don’t have any of that.”

Last month, the Malaria Communities Program announced five grant recipients, one being the Minnesota International Health Volunteers.

Laura Ehrlich, the organization’s international program director, said volunteers will spend the next three years using the $1.5 million grant to implement a Uganda Malaria Communities Partnership in two regions of Uganda.

The Malaria Communities Program, a $30 million plan under the President’s Malaria Initiative, started in December 2006. Its goal is to provide funding and resources to community and indigenous organizations that are working to fight malaria in Africa.

Ehrlich said receiving the grant was motivating.

“We were really excited and gratified to get the grant,” she said. “We have the opportunity through this grant to really make a difference.”

The main purpose of the Uganda Malaria Communities Partnership is to reach women and children under age 5, as well as pregnant women, she said.

It’s important to focus on those children because they have a greater chance of contracting cerebral malaria, she said.

They will also focus on pregnant women because many don’t use mosquito nets even when they’re available, Ehrlich said.

“They don’t want to sleep under them when they are pregnant,” she said.

What is malaria?

Malaria is a serious and potentially fatal disease humans can contract when mosquitoes carrying malaria-infected blood bite them. The disease can be caused by any of four parasites, according to the Centers for Disease Control and Prevention. The most serious is Plasmodium falciparum, a parasite common to many parts of Africa.

According to the CDC, there were 1,528 cases of malaria reported in the United States in 2005, seven of which were fatal. Annually, between 300 and 500 million malaria cases occur worldwide, and about 1 million people die from it.

Michelle Riehle, a research associate in the microbiology department, has studied the disease and how it behaves in mosquitoes.

“One important thing is that mosquitoes that are resistant to malaria are more prevalent than people originally thought,” she said. “The vast majority of the population is not what’s responsible for the transmission.”

These results could lead to better mosquito-control research, Riehle said.

“We’ve got to figure out how to tip the balance in the favor of the people by tipping the balance in favor of resistant mosquitoes,” she said, a strategy that could work better than attempting to eradicate the entire mosquito population.

Malaria requires three living things in order to spread, Riehle said – a mosquito, a human and the parasite. Research like Riehle’s focuses on the mosquito and parasite’s interactions, she said, while other researchers focus on malaria’s effects on humans.

Since no malaria vaccine exists, a person infected with the parasite must take an oral medication to treat the disease, assistant professor of medicine David Boulware said. Over time, however, the parasite develops a resistance to the medication.

Berezovsky had to start taking medication before her trip to protect against malaria, she said.

“I took a pill every day called Malarone,” she said.

According to the pharmaceutical company GlaxoSmithKline, Malarone is approved for the treatment and prevention of Plasmodium falciparum malaria in adults and children who weigh at least 25 pounds.

Berezovsky said she was lucky to have good medicine; she didn’t contract malaria during her month-long stay in Kenya.

She said, however, she had to continue taking the pills when she returned home, as a precaution.

University epidemiology graduate student Amenah Babar spent time during the summer in Mali working with the National Institutes of Health and researchers who are developing a malaria vaccine.

While she didn’t do clinical research herself, Babar helped gather information about malaria trends for the research.

“I was working more on the observational studies,” she said, “sort of collecting data to see how prevalent malaria was in that area so you can figure out what you’re up against.”

Babar said the research done in Africa is yielding important results.

“These vaccines have shown preliminary effectiveness and also safety,” Babar said. “Those are the two primary things you’re looking at when you’re looking at vaccines.”

The politics behind malaria

The President’s Malaria Initiative began in June 2005, with a pledge to increase malaria funding by $1.2 billion over the next five years.

The initiative’s goal is to reduce the number of malaria deaths by 50 percent in 15 African countries by 2010. The U.S. government also challenged other countries, private foundations and corporations to increase their efforts in stopping the spread of malaria.

The Minnesota International Health Volunteers organization, founded in 1979, has been working in Uganda for three years organizing community health programs to provide resources to combat malaria.

The organization is also working with the Malaria Consortium and the Malaria and Childhood Illness NGO Secretariat on the project.

Ehrlich said the organization is working in the northern part of Uganda in the West Nile region and within five districts.

The volunteers will also be working in three districts in the Karamoja region, she said.

They expect to reach 363,961 people in the West Nile region and 175,460 people in the Karamoja region based on census estimates, she said.

Ehrlich said they will also be training local community organizations on how to provide malaria education and referral information, as well as on providing medication and insecticide-treated mosquito nets.

“There is a lot of interest in malaria right now,” she said. “It’s the No. 1 killer in Africa, particularly for children.”