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Mission Man

David Colwell

Mission Man (continued)

These findings were an impressive start at establishing some kind of controls that might be reproducible elsewhere. This past July, the National Institute for Allergy and Infectious Diseases (NIAID) designated JHMRI as an International Center of Excellence in Malaria Research (ICEMR), in part because of the Institute’s work with Thuma. Part of the multimillion dollar, seven-year ICEMR grant will strengthen the Macha collaborative, allowing Hopkins researchers to better share and implement their ideas with other ICEMR grantees studying endemic malaria in Asia, Latin America and the Pacific Islands.

JHMRI director Peter Agre says the money may allow the research in Macha to move more quickly into wider practice. “This is, I think, a big story waiting to unfold,” Agre says of Thuma and Hopkins’ work. Over the past decade, Macha “has led all the clinical activity in their district. They’ve gridded it via satellite technology, identified every hut, measured the hut, estimated the number of people living in the hut, identified the presence of water nearby—it’s all fully defined.” During the rainy season, Agre notes, researchers led by Zambians Aniset Kamanga and Petros Moono developed a cell phone text messaging system between mobile field clinics and JHMRI’s Macha data collection center to communicate and record who is diagnosed with malaria and where. After the rainy season, health care workers return to look for and treat carriers. “This may be the most important advance,” says Agre, a Nobel laureate. While looking for asymptomatic carriers may seem obvious in retrospect, he says, “people hadn’t done it because it required an investment. But now, with modern molecular diagnostic tests, we can identify who is carrying the parasite.”

Agre says that with the ICEMR grant, Macha—and what’s discovered there—will be juxtaposed against two other field sites; Nchelenge, Zambia, just a stone’s throw from the border with Democratic Republic of Congo, an area where epidemic malaria has never been controlled; and Mutasa, an area of Zimbabwe once under control but now devastated by the disease. “Macha is our reference point where malaria is coming under control, and Phil’s a principal in all our international activity [in Africa]. So we have a good series of viewpoints to establish whether the Macha experience can be transferred,” says Agre.

For his part, researcher Bill Moss, MD, MPH, believes that at least part of the Macha model will benefit other areas. Moss, who is investigating the epidemiology of symptomatic and asymptomatic malaria, gametocytemia and changes in immunity in Macha, says that while different regions may have different epidemiological features, the work done in Macha could yield more efficient, exportable control efforts. He points to Doug Norris’ investigations identifying vectors and their behaviors: when they like to feed (day vs. night), where (indoors vs. the fields), on whom (men vs. women, children vs. adults) and for how long (a quick rush at dusk vs. an all-night bite-a-thon). If it’s found that a vector bites during the day and outdoors, Moss says it might be less effective to distribute insecticide-laden bed nets for indoor use. Overall, says Moss, an Epidemiology associate professor, “I don’t think it will be a complete model that’s translatable from one area to another, but I would hope we could understand what the key factors are that you need to know in a particular area”—in order to arrive at the best package of malaria control interventions.

While investigations mature under the ICEMR grant, one thing is already clear to JHMRI’ers and Phil Thuma: The man’s mission can and will go on, perhaps long after he’s hung up his shingle. “He’s created capacity building,” Peter Agre says of Thuma’s little miracle in the middle of nowhere. Agre believes that Thuma’s model may convince Zambian health officials to go where they’ve rarely gone before: accelerating an academic track for homegrown PhD-level researchers—who bring a passion that comes from personal awareness of the devastating disease—and making sure they get paid a reasonable wage.

That’s the type of passion Phil Thuma can understand. Outsiders may see him as unique, but he insists he’s not. Well, maybe a little. “I’m like Don Quixote. I tilt at windmills. If there’s a problem, I’ll invest myself and work hard at it,” says Thuma. “I was raised by my Dad, who said, ‘You need to leave the world a better place.’”

Somewhere, you have to believe Alvan Thuma is smiling.

Comments

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  • Kathleen Stuebing

    Ndola, Zambia 01/13/2011 01:32:27 AM

    This is an excellent article that accurately presents Macha and the incredible ways through which Dr. Phil Thuma has brought relief from malaria. Both of our children were born at Macha by Caesarean section, and I had no complications or infection, attesting to the quality of the medical care in the middle of the African bush. Now Dr. Thuma has added his malaria triumph, which your article describes so well. We eagerly await the time when malaria is controlled to such a degree where we live in urban Zambia. Our students and their children regularly suffer from malaria. This is a wonderful story of hope for all malaria ridden places, and it rightly honors the man who has given his life to pursuing this goal--Dr. Philip Thuma. Thank you.

  • Lee Nell

    Florida, USA 11/14/2012 12:14:32 PM

    Great article about a great man. Phil is a genius, in my opinion, the most unassuming person I've ever known considering the miracles he's accomplished so far, and, I'm proud to say, my brother-in-law. As the article notes, he is totally committed to the people in and around Macha and to eradicating this dread disease. As I've always said, my money is on the tenacious Phil Thuma to win that battle. Maybe then, and I'm sure only then, would he even consider accepting some credit for his success in the remarkable life's work he has undertaken. Maybe.

  • Juliet Laverley

    Sierra Leone 07/13/2013 11:52:01 AM

    This is great work it takes a special person to make this happen, I wish we can clone Dr. Thuma for other areas in west Africa. Is there opportunity for adoption of best practice and protocols from his experience and success for other African countries with similar challenges?

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Macha Slideshow

Fighting Malaria in Macha

Photographer David Colwell journeyed to Macha, Zambia and returned with images and sounds of malaria research and prevention.

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