Slide2: History of malaria and
antimalarial treatment M. Lontie
MCH, Leuven
2006
Mala aria (Roman fever) (It.)Agues and feavers (E.)Palus (L.) = marsh (E.)Paludisme (F.)Moeras-, polderkoorts (NL.): Mala aria (Roman fever) (It.) Agues and feavers (E.) Palus (L.) = marsh (E.) Paludisme (F.) Moeras-, polderkoorts (NL.) Malaria
Malaria in antiquity: Malaria in antiquity Region between Tigris and Euphrates was malarious (2000 BC).
Nei Ching Canon of Medicine (1700 BC).
Egyptian mummies with enlarged spleens (1000 BC).
Hippocrates (460-370 B.C.): Hippocrates (460-370 B.C.) Hippocrates, “father of medicine”: feavers with black bile.
Clear discussion of quartan and tertian fevers in his Book of Epidemics.
Noted relationship between enlarged spleens and marshes.
Alexander the Great (356 B.C. - 323 B.C.): Alexander the Great (356 B.C. - 323 B.C.)
Cinchona officinalis (Rubiaceae) : Cinchona officinalis (Rubiaceae) Eastern slopes of the Andes.
1638: Countess Anna del Cinchon, wife of the Viceroy of Peru.
1640: Jesuit’s powder.
Allowed European conquest of the tropics.
1672: Robert Talbor’s remedy: an infusion of cinchona powder in white wine: 1672: Robert Talbor’s remedy: an infusion of cinchona powder in white wine
Chinine and the Dutch: Chinine and the Dutch 1865: the Dutch buy 450 grams seeds from Charles Ledger in London.
Cinchona ledgeriana in Java (10 % chinine in the bark).
Amsterdamsche Chinine Fabriek till WWII.
20 mg quinine / bottle of tonic: 20 mg quinine / bottle of tonic
Nobel Prize Winners and Malaria: Nobel Prize Winners and Malaria 1902: Sir Ronald Ross
1907: Charles, Louis, Alphonse Laveran
1927: Julius Wagner-Jauregg
1948: Paul Hermann Müller
Sir Ronald Ross (1857-1932): Sir Ronald Ross (1857-1932)
1897: role of the mosquito.
Nobel prize: 1902
Alphonse Laveran (1845-1922): Alphonse Laveran (1845-1922) Physician of the French Army.
1880: Constantine, Algeria, The malaria parasite: Laveriana, Plasmodium.
Nobel Prize: 1907
Malariatherapy for syphilis: Malariatherapy for syphilis
Julius Wagner-Jauregg (1857-1940) : Julius Wagner-Jauregg (1857-1940) Austrian psychiatrist.
Malariatherapy (1918) with Plasmodium vivax.
Der progressiven Paralyse (Dementia paralytica), also der fortschreitenden Gehirnerweichung als Folge der Syphilis.
Nobel prize: 1927
Ab 1953 zierte er den 500 Schilling-Schein.
NS-sympathy.
Malariatherapy for HIV?
Paul Hermann Müller (1899-1965): Paul Hermann Müller (1899-1965)
1939: Dichloro-diphenyl-trichloro-ethane (DDT).
Nobel Prize: 1948
Exoerythrocytic stage (e.e.): Exoerythrocytic stage (e.e.) Shortt H., Garham P. et al. 1948. Ross Institute at the London School of Hygiene and Tropical Medicine.
E.e. or liver stage of rhesus monkeys and later of human volunteers.
American Civil War (1861-1865): patients with mosquito nets, Washington D.C.: American Civil War (1861-1865): patients with mosquito nets, Washington D.C. 50% of the white soldiers got malaria annually
Germany in the interbellum: Germany in the interbellum
Malaria of birds (W. Röhl).
1924: 8-aminoquinolines: plasmochine, primaquine.
1930: mepacrine, quinacrine, Atebrine.
1934: 4-aminoquinolines: chloroquine.
General Douglas MacArthur is quoted as saying (WWII): General Douglas MacArthur is quoted as saying (WWII) "This will be a very long war, if for every division I have fighting the enemy, I must count on a second division in the hospital with malaria and a third division convalescing from this debilitating disease.“
Five hundred thousand American troops alone would catch malaria.
Amino-alcohols: Amino-alcohols Wars in South-East Asia (Vietnam)
WR 180409: enpiroline
WR 171669: halofantrine
WR 142490: mefloquine
Eradication of malaria: Eradication of malaria
Belgium: 1938
The Netherlands: 1958
USA, Cuba, Australia, Israël ...
Slide23: M. Wéry, 1995.
Malaria: numbers in millions : Malaria: numbers in millions
300-500 annual cases
1-2 deaths (mainly children < 5y)
Mandell et al., 2005 - WHO, 2001
In 1931 Mussolini began the 3-year project to drain and reclaim the Pontine Marshes for 3000 new farms. : In 1931 Mussolini began the 3-year project to drain and reclaim the Pontine Marshes for 3000 new farms.
Slide29: Eradication of malaria
1934: Hans Andersag at Bayer discovers chloroquine
1939: Paul Müller at Geigy discovers DDT
1951: Sardinia malaria free
1955: WHA (WHAssembly): goal of global eradication
1955-1969: WHO uses DDT and chloroquine
50’s: DDT-resistance
1962-1970: chloroquine-resistance
1955-1965: expenditure of $ 1.4 billion
1969: WHO back to malaria control
1975: Europe free of malaria for
first time in history Courtesy of C.D.C
Parasitology: Parasitology orphan parasites
orphan drugs
the disaster of the ban of DDT
The Lancet. 2000. 356: 265 and 1189
(orphan reimbursement, B)
Threats: Threats Global warming
El Nino (little child in Spanish, arriving around Christmas).
Dams
Diama dam in Senegal and large outbreak of Schistosoma mansoni infections. 1996. Kongs et al. Trop Med Int Health. 191-8.
The Lancet. 2001. 570-1.
SPF 66 malaria vaccine: SPF 66 malaria vaccine Manuel Patarroyo from Columbia donated the patent of the vaccine to the WHO.
Lancet. 1993 Mar 20;341(8847):705-10.
"It's not only the first malaria vaccine but the first against any parasitic disease of humans."
The Lancet, 364, Nr. 9443, October 16-22, 2004: The Lancet, 364, Nr. 9443, October 16-22, 2004
“The road toward a safe and efficient malaria vaccine being available and useable on a large scale, or even incorporated into an expanded programme of immunisation, will be long and chaotic.”
Slide36: Recent history of the World Bank's work on malaria
The World Bank co-founded the Roll Back Malaria (RBM) Partnership in
1998. Since July 2000, the Bank has committed about US$100-150 million
in funds earmarked for malaria control. This includes only health sector
investment credits and grants, as well as commitments through broad
programmatic operations such as Sector-Wide Approaches (SWAps).
Total World Bank support for malaria control was higher, due to financing
through debt relief, multisectoral operations such as Poverty Reduction
Support Credits (PRSCs), Emergency Recovery Credits and Social Funds.
However, it is difficult to quantify exactly how much of these programmatic
operations went to malaria control, since such operations do not track
details of inputs into specific disease control programs.
RBM is enabling countries to take effective, sustainable action against malaria by focusing on : RBM is enabling countries to take effective, sustainable action against malaria by focusing on
Preventing and controlling malaria during pregancy.
Promoting the use of insecticide-treated mosquito nets as a means of prevention.
Dealing effectively with malaria in emergency and epidemic situations.
Providing prompt access to effective treatment.