The $1 Pill That Could Beat Malaria For Good: Too Good To Be True?

Malaria is one of the biggest killers worldwide. It's the fifth biggest killer in Africa (about 90 percent of malaria deaths occur in subsaharan Africa) and as of 2012, after a decade-long intervention program that slashed deaths by almost half in the region, it still killed 564, 000 people in subsaharan Africa alone and infected 207 million people around the world (Source: WHO Factsheet).

It's easy to think of diseases that have claimed similar numbers of lives, and which we have conquered, largely by vaccination. While the WHO calls malaria "entirely preventable and treatable," the preventions that are available take the form of mosquito nets and prophylactic chloroquinine or treatment with opther quinnine-like drugs, and the treatments are by African standards expensive.

There's a complication, too: the most dangerous type of malaria, falciparum malaria, is resistant to chloroquinine and often at least one other drug too. Quinnine still works, usually, but it's hard to get. And other treatments, like doxycycline, atovaquone and proguanil hydrocholoride, come with unwanted side effects. 

The final nail in the coffin of a treatment-and-prevention program that could wipe out malaria is the animal reservoir. That's a group of nonhuman animals that carry the disease, so even if all the humans around you are malaria-free you can still catch it from an animal, and then infect your family, friends and neighbors. Some diseases, like flu, have animal reservoirs in the form of birds and pigs, so we get bird flu, swine flu and so on. We spend a lot of time with those animals, so it makes sense that we can share diseases back and forth. And it's thought that AIDS may have been an ape of monkey disease that crossed over to humans by hunting. But the relationship between humans and malaria's animal reservoir is different from that between us and our food animals — because they feed on us.

Experience suggests that what really protects children from diseases you can catch is herd immunity, which is why vaccination is so important. We've literally rid the earth of smallpox by vaccination, and came close to totally obliterating polio before the Taliban started telling Afghan mothers that the oral polio vaccine contained poison and would make their children infertile. (Now there's a massive polio outbreak in Afghanistan and other areas controlled by the Taliban.) We can't protect people in poor countries with expensive nets and long treatment programs. We need a vaccine.

READ Malaria: Radical Change Of Strategy Offers Hope For Eradication Of Disease

So if we can vaccinate against so many other things, why isn't there a malaria vaccine already?

Vaccines work by teaching your immune system what a virus, bacterium or even a protovirus looks like so it can attack the invader before it breeds and causes damage. But polio, smallpox or even TB remain basically the same, mutating only very slowly. Malaria has a six-stage lifecycle and in every stage it looks completely different. Because it's not a bacterium; it's a plasmodium protozoa. 

Catching The Shape-Shifter: Malaria And The Vaccine That Isn't A Vaccine

How do you teach your immune system to recognise a shape-shifter?

You don't. 

You look for another way.

Working on a drug to treat malaria, scientists at Dundee University discovered something surprising: their drug, known only by its code name, DDD107498, has the abillity to attack malaria parasites during eachs tage of their lifecycle. The drug attacks a protein that malaria pasrasites use to transmit genetic information, and that protein is present and vital at every stage of the parasite life cycle. So however much plasmodium shape-shifts, the new drug can still zero in on it.

It's not a true vaccine, as such, but when you're immune to malaria, who's counting?

Aid agencies, governments and doctors are counting. They have budgets, and many developing nations' governments can't afford long courses of treatment with expensive drugs. So it's a good thing DDD107498 only has to be used once.

Even better news is that the team developing it expect that, when it goes into full production, it will retail for $1 a dose or thereabouts: low enough to offer the hope, at last, of eradicating malaria. Even if we can't do that we can cut down on the deaths and disabilities malaria causes every year, and save children, pregnant women and old people who would otherwise have become just another one of the 564,000. 

While it's tempting to think of things that happen on the other side of the world as not really our problem, something we should maybe donate money to but don't need to feel much of a sense of urgency about, malaria is truly a 21st century disease: it's cosmopolitan, democratic, and well-traveled. Multidrug resistant malaria is a horrifying African reality that threatens to spread to India; North and South America both have malarious zones. Until Mussolini drained the swamps around the city, Rome was malarious right into the 20th century. 

READ Drug-Resistant Malaria Taking Over Asia

Malaria is your problem if you travel to tropical countries, especially in Africa, but it's your problem if you don't too. And when the only treatment that still works causes mental illness and brain damage, we should all be grateful to the Duncee team for DDD107498.

Hope they come up with a better name, though.