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Six Experts, Six Answers


Six Experts, Six Answers

What is the most promising near-term approach for malaria control?

Carlos C. “Kent” CampbellWhat is beginning to develop in several countries is that the use of bed nets, when applied by really good programs with coverage rates in the 70 percent range,is driving down transmission rates, as reflected by parasitemia prevalence, to levels we had not anticipated, and it potentially has the ability to change the mindset on how we approach malaria. It's not some theory; I’ve seen the data—it's not published yet—and it’s encouraging.

The perception is, in the minds of some policy--makers and funders, that bed nets—even if used perfectly by the whole population and combined with effective drugs—do not have the intervention power to actually intervene on malaria transmission at a community-wide level. The sense is that these interventions can’t get you to a place where malaria becomes so low that a program could be oriented to addressing transmission in a focal way, finding parasitemic people and treating them. And that view has been taken to the extreme of saying we need to be careful of how much money we invest in programs based on currently available interventions like bed nets. We need continued investment in both vaccine research and intervention programs.

The real challenge now is selling transmission control as a compelling near-term strategy, but it’s not sexy. And the evolving evidence that current interventions have greater power to control trans-mission than we previously understood will help to focus research on malaria vaccines that actually block transmission.

Carlos C. “Kent” Campbell, MD, MPH, is director of the Malaria Control Program at Program for Appropriate Technology in Health (PATH).

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  • Dr. C. Nagaraj

    Bangalore, India 02/08/2011 10:47:20 PM

    I wish to inform you that already resistance of Pf has occurred and I have detected resistant Pf from Karnataka, Maharastra and Orissa in India - resistant to ACT (Artisunate +SP) by therapeutic efficacy method (in vivo). I can send my findings to you if are interested. I have lot of interesting findings which I wish to discuss - gametocyte increase after ACT, side effects of ACT, etc.

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