If historians were to pass judgment, one of the most instructive chapters in the annals of infectious disease control might be the failed effort to eradicate
malaria in the mid-20th century. According to Dr. Nicholas White, a distinguished professor of tropical medicine at Mahidol University in Bangkok, Thailand, the story of malaria control remains far from finished.
White will explore the past and future of malaria
treatment in the upcoming NIAID-sponsored Gorgas Memorial Leon Jacobs Lecture. From the earliest use of Chinese sweet wormwood and quinine-containing Cinchona bark to the modern-day use of combination treatments, he will discuss the rationale for current treatment recommendations and describe how malaria drugs ultimately could contribute to eliminating
White will deliver his lecture, "Treating Malaria: The Long and Winding Road," at 3 p.m. Thursday,
Sept. 27, in Bldg. 50, 1st floor Conf. Rm. 1227/1233.
A century ago, the possibility that malaria would be eradicated seemed exciting and real. Two of the earliest Nobel prizes in physiology
or medicine were awarded in 1902 to Ronald
Ross, who demonstrated that mosquitoes spread malaria, and in 1907 to Alphonse Laveran,
who discovered the Plasmodium parasite that causes the disease.
Malaria eradication through mosquito control became a major public health effort worldwide in the first half of the 20th century. After World War II, these efforts, which included the use of DDT, intensified. And not without success-incidence of the disease fell dramatically in the United States and Europe.
Nevertheless by the mid-1960s, many considered
the goal of worldwide malaria eradication unattainable. Eradication efforts were largely abandoned. In the late 1960s and early 1970s the disease resurged, fueled by drug resistance, problems with mosquito control and faltering public health infrastructures in many countries.
By the 1980s, malaria was reemerging as a huge problem in many parts of the world, which White witnessed firsthand.
He has spent his entire career practicing medicine in tropical settings. He is principal
fellow of the Wellcome Trust and chairs the Wellcome Trust Tropical Medicine
Research Programmes in South-east Asia and the Oxford Tropical Medicine Network, which encompasses research groups in Thailand, Vietnam, Laos, Kenya and The Gambia.
According to the World Health Organization, about 40 percent of the world's population-some 2.5 billion people-are currently at risk of malaria. Every year, 500 million people become severely ill with the disease and more than 1 million people die. Children are most affected.
"We should now reengage with the possibility of getting rid of malaria," says White. There is tremendous opportunity today, he notes, because of renewed attention to the problem and new funding flowing into malaria control efforts from governmental, non-profit and private company sources. New interventions are also available.
White has championed the use of artemisinin derivatives as treatments for malaria.
Artemisinin, a natural product found in the sweet wormwood plant, has been a traditional treatment for fevers in China for nearly 2,000 years. In the 1970s, Chinese research teams succeeded in isolating artemisinin for the first time and proved that it was a powerful antimalarial compound. The derivatives of artemisinin
have proven even more effective; their road to the clinic is one of the main subjects of White's talk.
His own clinical studies involving these antimalarial compounds in the 1980s and 1990s have convinced White that their use, along with mosquito control measures such as the distribution of insecticide-treated bed nets, could dramatically
reduce malaria mortality and might ultimately contribute to the elimination
"These drugs are extraordinary. They are much better at treating severe malaria, they have proven safe and effective and they are a first-line treatment in many parts of the world," White says. "Malaria experts may be reluctant to use the term 'eradication,'
but today we have what we need to control and eliminate the disease."
White received his education at the University of London, earning a B.Sc. in pharmacology
and first-class honors in 1971. He graduated with honors in medicine and pathology and applied pharmacology and therapeutics in 1974, and was awarded a doctorate in medicine in 1984. He was subsequently awarded a D.Sc. from the University
of London in 1995. In 2001, he was elected a fellow of the Academy of Medical
Sciences and in 2006 he was elected a fellow of the Royal Society.
The Gorgas Lecture is hosted by NIAID's Laboratory of Parasitic Diseases and Laboratory of Malaria and Vector Research. For more information, contact Julie Marquardt at (301) 496-5717.