World Malaria Day 2018

Posted 23 April 2018

"Ready to Beat Malaria"

April 25 is World Malaria Day, an international observance recognizing global efforts to control malaria. To honor the day, ASTMH asked its leadership working in malaria, “Who inspired your commitment to ending malaria?”

 
Regina Rabinovich, MD, President — “I could answer this so many ways. My parents, of course.  My mentors over the years, Phil Russell, John LaMontagne, Carolyn Hardegree. Those whose work I admired even before I knew them: Pedro Alonso, Awa Marie Coll-Seck. But the real answer is the children. Walking into my first African hospital during malaria season, I saw several children to a bed because they were already overtaken by the local epidemic. Having watched infectious diseases literally disappear during my training, I believed a vaccine would be critical and that a more comprehensive strategy would be needed, targeting multiple points with different tools. Malaria is endlessly fascinating, challenging for the long-term and a worthy enemy. As a pediatrician, I know 216 million cases or so happen every year. Anyone who has had the disease understands the impact it has across many aspects of society, from how many children one decides to have to how it can change your family's livelihood. But that hundreds of thousands of children die from a disease that is treatable and preventable—that’s a worthy adversary. Malaria must die...”
Chandy C. John, MD, FASTMH, President-Elect ​— ​"I was inspired to work in malaria because of all the children I saw in Nigeria who had malaria. No single child comes to mind because the disease was so common in 1989, when I was in Nigeria on an American Medical Student Association (AMSA) International Health Fellowship as a resident; it was overwhelmingly the most common reason for clinic visits and hospitalizations at the hospitals I worked in. At that time, there were very few U.S. pediatricians working in malaria research. One of my mentors in Nigeria, Cindy Howard, taught me the value of bringing pediatric expertise to the care of children with malaria. Subsequently, my research mentor Jim Kazura taught me how important it was to ask precise questions to get at how children develop immunity to malaria, and my colleagues Bob Opoka and John Vulule taught me how to develop good research teams to answer those questions. But it all started with seeing dozens of Nigerian children sick with malaria every day. We’ve made huge progress since then, but I still see many children with malaria, including severe disease, in Kenya, Uganda and sometimes the U.S. Remembering our progress—but knowing we still have much to do—inspires me to keep fighting against malaria and its long-term complications." 
Philip Rosenthal, MD, FASTMH, Editor-in-Chief, AJTMH — “After training in internal medicine, I decided to pursue tropical infectious diseases due to a nascent, unfocused interest in global medicine. Luckily, I met Jim Leech and decided to train with him at UCSF. Jim suggested that I study proteases of malaria parasites, an area different from his main focus. This idea was sparked by Jim McKerrow, who presented his work on proteases of other parasites at a UCSF seminar, held while I was still toiling on a clinical service. One Jim caught the interest of the other with excitement about proteases, and the other had the wisdom to move in this direction, and thereby allow me to begin my career in malaria research. Since my early days studying the biology of malaria parasites I have moved to an array of topics in malaria research, from drug discovery to translational studies in Africa. But the beginning of it all was my poorly formed interest in tropical medicine and the wise counsel of my mentor, who guided me to an area that was ripe for the picking. Mentoring is important! And, malaria research, in all its forms, has been incredibly rewarding.”
Nicole Achee, PhD, Councilor — "It was during my first trip to Sumba Island, Indonesia, when I experienced the wide spectrum of malaria’s impact on health systems and communities. Many clinics were unable to manage infections, knowledge of death amongst children and, perhaps the most influencing at the time, the lasting effects of morbidity. At one village, an elderly woman held a child who had recovered from severe cerebral malaria. His size suggested he was 2 but he was actually 5 years old. He could not walk nor speak. The challenge of long-term care for this child within the daily life of that family will be immense. The image of that day remains with me." 
Abdoulaye Djimde, PharmD, PhD, Councilor — “When I was a little boy I had a brother whom I loved and cherished very much. One day during the rainy season he got sick, very sick, and he was taken to the hospital. He never  came back. My dad told us that, "Although we would no longer be able to play with him, he would always be with us in our hearts." He had malaria. I decided to become a doctor when I grew up to make sure no one else would lose his brother to malaria. I eventually did pharmacy studies and started a retail pharmacy. Every year I would send boxes of antimalarial drugs to my dad before each malaria transmission. There was enough medicine for not only my family but other relatives and even neighbors. A few years later, I joined the Malaria Research and Training Center in Bamako, Mali, initially as a volunteer. My involvement with malaria research is not just for a career or a paycheck – it has that personal touch that keeps me going even when things are difficult."
David A. Fidock, PhD, FASTMH, Councilor — A moment that crystallized my dedication to combatting malaria came during my second year of my PhD studies, which I was pursuing at the Pasteur Institute in Paris in the lab of Pierre Druilhe. It was 1990, and I had gone to Kenya to study human T cell responses to Plasmodium falciparum liver stage antigens. Working from a WRAIR lab in Kisumu in western Kenya, a Kenyan scientist took me to a local healthcare clinic one day run by a physician who had earned his medical degree in the U.S. and had returned to Kenya to treat local patients. In the waiting room a young woman sat quietly, holding a moribund child in her arms, nestled on her lap. She was silent and they were alone, waiting for the physician. In the next room, he told me that the child had cerebral malaria and was being treated (I don't know with which drug, perhaps quinine at the time). He also said the chance of the child recovering from his comatose state and surviving was only one-half, even with effective treatment, because of the advanced state of infection. The mother would have known this, yet was quietly stoic. She knew that no outpouring of grief could help, only just holding him and caring for him in this small hut with a single physician and no others. I saw the silent tragedy of malaria poised to steal a child’s life. I never found out if the child recovered. This moment hardened my resolve to dedicating my professional life to alleviating the suffering that malaria causes across Africa.” 
Jetsumon Sattabongkot Prachumsri, PhD, Councilor — “My first job at the AFRIMS involved research on malaria transmission in which I had to meet with malaria patients at malaria clinics and visit malaria villages in Thailand. It was the first time that I saw malaria symptoms and learned about malaria treatment by public health staff. I also learned how the government had controlled malaria at that time. The local staff worked very hard to spray houses in malaria-endemic areas and where they could reach by feet only. I also learned that Thailand has had multi-drug-resistant parasites, thus malaria treatment has been controlled by the nation and drugs were provided for free. The treatment was complicated and sometimes patients did not complete the medicine after getting better. There was no suitable formula for young kids – I saw a little girl cry when her mother was trying to feed her the medicine. My experiences working in endemic populations has inspired me to do more research aiming to find ways to interrupt malaria transmission, get better treatment and to innovatively prevent people from (contracting) this disease.”
Stephanie Yanow, PhD, Associate Scientific Program Chair — "My early training was in cancer biology and I took what I considered to be a leap of faith by changing my field of research to study malaria. I could not have succeeded without the mentorship from my post-doc supervisor, Terry Spithill. He welcomed me to the field and fueled my excitement to learn about this fascinating parasite. I distinctly remember him telling me early on, ‘With malaria, always expect the unexpected.’ This held true during my post-doc in his lab where we unexpectedly found that an anti-tumor drug could effectively kill the parasite, and it holds true in my own lab’s work today. Thanks to Terry, I decided to dedicate my career to malaria and I will never underestimate this formidable parasite."
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