Focus 580; Malaria: History, Current Research, Future Hopes

In the first hour of the program today we'll be talking about malaria. Malaria is a disease that is one of the world's most common and serious tropical diseases it's also one of the world's great killers. It kills more than a million people a year. Malaria is a disease that is both treatable and preventable and in fact malaria has been eradicated from many developed countries. It does however continue to be a major health problem in countries where poverty prevents access to effective treatment. This morning in this hour of the show we'll be talking about malaria. Talk a little bit about the basics of the disease what it is how it works. Also talk a little bit about treatment and prevention and talk about some of the progress that has been made recently toward developing a vaccine. And our guest of the program is Dr. Robert desu it's he's an expert on tropical disease. He is both a fellow of the American Society of tropical medicine and hygiene and the Royal Society of tropical medicine and hygiene. He's done research in a number of countries Nigeria Singapore Thailand Hawaii. He's member of the World Health Organization's expert committee on parasitic diseases and has served as consultant to a

number of governments including Burma Fiji Sri Lanka Bangladesh India Tonga. He's written a number of books about tropical disease. Just one I want to mention it specifically deals with the subject we're talking about here this morning and that is a book entitled The malaria capers more tales of parasites and people research in reality. That book was published by WW Norton and. In 1991 He's joining us this morning by telephone. And as we talk questions are certainly welcome the only things that we ask of people calling into the program is that they're just try to be brief in their comments and we ask that so that we can keep the program moving along getting as many different people as possible. But of course anyone who is listening is welcome to join the conversation. The number here in Champaign-Urbana is 3 3 3 9 4 5 5. We do also have a toll free line and that's good anywhere that you can hear us and that he has 800 to 2 2 9 4 5 5 so. And the point here if you have questions you certainly should feel welcome to pick

up the telephone and join in. Dr. desolate celo Good morning. I want to thank you very much for talking with us today. My pleasure. We certainly appreciate it. Just overall I'm I'm sure that we can try again and hit all the basics and talk about the things that I mentioned and and of course part of the reason I think our interest in reviewing the topic was to talk a little bit about some of the recent news relatively recent news about progress toward a vaccine. But just as a way of starting I wonder how it is that we assess where we are now with malaria particularly because as I said on the one hand. There are places countries that are in temperate climates where you would expect there might be malaria where essentially it's been eliminated and yet on the other hand there are other places and we are talking about the developing world I think in fact the vast majority of cases of malaria are in Africa and most of them are in children and we would have to say that because we know we should be able to prevent and deal with that and it shouldn't be that kind of a

problem so I guess how how is it we look at the progress or it may be in some cases lack of progress in dealing with this disease. It's really a lack of progress. I think we probably that it was 50 years ago. Malaria has never really been touched in Africa where the great Depository is and it is coming back in high numbers high more bad fidgety and mortality. Back to Southeast Asia where there is drug resistant insecticide resistance people resisted and. It's I think it's a kind of a frightening situation again after being suppressed or under control in many parts of the world for long. You know we even had an hour a little lab mini outbreak in Palm Beach.

I think it was last year some Thai mosquitoes are still around. Well that said it is true. And people also ought to know and if they don't that malaria certainly there was a time when malaria was a serious problem in the United States. And as you mentioned pretty much is not something we worry about anymore although there are I believe that some figures I have here for 2002 say that there were something over 13 hundred cases of the disease reported in the United States 2002 including eight people who died so that even though since the early 50s at least on paper we say that malaria was eradicated has been eradicated in the United States. Yeah it's mostly in travelers. But again it was the American disease. It it had the lead the side was white. You

know we built this house we came from Hawaii he had the first visit there that summer was Mrs. Quadri maculatus that they had not fully. Do you know if it carried most of the malaria here in the United States but it was probably one of the most serious problems all the way up. It's not a tropical disease. We had it all the way through Maine at one point. Why. I guess with your response you know invites this question why is it that we actually seem to have taken some steps backward in dealing with malaria. It's been in part I suppose is that somehow we should expect things like eventually disease causing organisms will become resistant to the treatments we have and the insecticides we will get to the point where insecticides won't work anymore that that's. Is that just something that we should

expect. Well. I always thought that the brainless creatures that I deal with somehow get to be smarter than all the Ph.D.s in the MTs and everything out there really kind of cunning little creatures. We've the truth is we've always had methods to deal with malaria. If one could apply that the cheap quick fixes that we expected in the system are no longer available. The drug was the sheet anchor like Laura Quinn which you could cure somebody for 50 said. Now requires a more sophisticated drug or it may cost $5. It's a kind of marvel comment that we're not willing to spend $5 to save a child's life.

The quick fix to real RI of the 50s was the application of DDT and for a number of reasons presumably will get to with later rod that has been mostly closed to us now. And. We just don't have the armamentarium but the cheap quick commentary that he had fifty years ago. We do when we have a couple of callers already rather than make these people wait. Why don't we find out what's on their minds and particularly have somebody here who is calling on the cell phones I want to get to them. That's line number one. Hello hello. I wanted to ask your collar or your visitor. I don't I had a splenectomy when I was 10 years old and I found out the hard way that I really shouldn't travel in malarial regions through a Peace Corps

experience I won't go into that. However I was wondering are the preventive drugs any better. Can I now safely travels. Well I would always take it Chad. You're at special risk because of the splenectomy for more fulminant course of malaria. However there are good. There are a number of prophylactic drugs in the States. Meth for Quinn is one although it may drive you a little bit batty. And one that is better than malaria. There's a new one called Malegaon that's available in the States even doxycycline taken daily for a short visit. Go for it. Let the splenectomy prevent you from traveling. Thank you Mike. That's my feeling about it.

OK thank you very much. All right well thanks for the call. We'll go to another caller here in Belgium. Nearby community lie number four. Hello. I'm going on I have a couple questions number one. One is malaria indigenous to New Rome. Or was it strictly just an African disease. A My take on it is that it was not indigenous to the new world we had the vet to see if he had the special Miskito that could carry it. It was brought in I think by the slave trade and to be explored at probably the European explorers because you're the was highly malarious particularly to Spain and Italy. So the the consensus is that there was no pre-Colombian.

Malaria in the New World. There are some people who found malaria in very deep jungle tribes somewhere in the Amazon and they think that this is proof this is malaria and syphilis of the big debate is where they hear before Columbus is tied and my take on it is that it's purely imported into the new world. Thank you. Another question or actually a comment in the early diaries of people who first settled in Indianapolis there was a serious malaria problem there when they first started growing this city along with Washington D.C. were very very serious hot beds of malaria. So it's a minority. And when it came in much came like a vengeance.

But the other question now really wanted to ask you about and you haven't really talked about it yet and want to step is what action. Is the disease and the reason I ask that is that it seems like malaria is almost a parasite in the way that it acts. Well it is. It certainly is of all definition as a parasite to begin to begin with this is this is absurd. Visit a 45 minute lecture or to speak in 45 minute segments. But it's malaria rather than malaria. There are four species of malaria in the one that is most fulminant and killed is falciparum it usually is associated with high temperatures. The the other one the other one that's fairly common is the Plasmodium 5 sacks and they call that a benign tertian but I've had them both.

Boy you may omit the cell surface but you feel just awful with the survivor. That usually comes in the northern tier is during the spring in planting season. Then there's a malaria I know valley but we have four species and we're susceptible to certain species that are in primates that are in monkeys and actually have as been free in Malaysia just recently where the monkeys the forested the monkeys came to the ground and got transmissions the humans of the first. So malaria is a parasite they all have a fairly common life cycle in that they invade the red blood cells.

That's the main cause of the anemia and destruction as well. The hope of solid The symptoms are fever and dry go up but the the kinds of symptoms can. It's called the great mimic you could have diarrhea you can have all sorts of say things that go wrong with it. If I might ask one last question. Is it always transferred to mosquitoes. Yes and no it is all always true Miskito. It is through mosquitoes. The main transmission of error is of course the possibility of it being with transfused blood and occasionally it's a congenital where the

newborn or the seat of the late stage feed diskettes it from the infected mother. Thank you very much for the car and thank you. Perhaps I should introduce Again our guest with his part of focus 580 Dr. Robert decimates He's emeritus professor of tropical medicine and medical microbiology at University of Hawaii nomics his home in North Carolina. He's done a lot of research on writing over the years about tropical disease. He's authored a book titled The malaria capers and more tales of parasites and people research in reality that was published by WW Norton in 1991 a little bit more recently of the book who gave painted to the Santa Maria which is again an exploration of various tropical diseases their origins and how they spread syphilis being one of them that's what the title refers to. That book also published by Norton Norton that came out in. Eighty seven questions again are certainly welcome the number here in Champaign Urbana 3 3 3 9 4 5 5 we do also have a

toll free line that's good anywhere that you can hear us and that is 800 to 2 2 9 4 5 5. As you mentioned there here are the basic And I think maybe people well understand that indeed malaria the diseases they're talking about are caused by parasites that there and they are transmitted by mosquitoes and not just any mosquito but a particular kind of mosquito. And so one of the main tools at least in the past that was used was to use insecticide specifically DDT and use that to try to get rid of the mosquitoes. So if you get rid of the mosquitoes then you get rid of the disease because you don't have the means of transmission. Then of course as people know DDT was taken out of use because of concerns about its end. Our mental impact obviously here there are tradeoffs. Do you think that that that was the correct decision should or should we have said yes maybe DDT has some environmental impact and it will not be good in some respects but in other respects here where it's the

best tool we have to fight the spread of this disease so that perhaps we should say we should continue to use it or we should have continued to use it at least some places. It certainly must must be used in getting it to control malaria in itself probably is not going to be the final Lancer is not one and that's it's all DD T was the most is the most powerful insecticide. It is unique. It is virtually none toxic. There's going to be some debate about that. But we've just had a meeting of the National Academies of Sciences to reconsider its reach. It has the properties of being residual. You're sure it's a DOD and once inside a house

and that it will have its insecticide will or repellent properties for up to six seven months. It was it is a great ride and it is being used to get in there. When the chips are down and places like the epidemic in South Africa back to DDT again it's it's any number of places to be used. And it was again dirt cheap environmentally. You know of the dead you speak nothing but good but I'm afraid St. Rachel may very well have in her own way and killed more people and destroyed a spree certainly. I'm sorry to be quite so strong about that but it's a. It speaks again a very impassioned topic

but it is coming back. The problem is we you know big joke amongst us is that the only thing that malaria eradication scheme eradicated for the malaria ologists and we just don't have quite the same knowledge where it should be strategically applied. Do you is it also a fair criticism the some people make that is another one of those cases where the people primarily affected by this disease are poor they're people of color there are people in the developing world and that for that reason when we look at understanding it and fighting it and preventing it it gets a pretty low priority for that for that reason. Well you know I started work. I was American but in the colonial British colonial it's a real anomaly in Nigeria and the people of the colonial the how it is we're very compassionate people

look at sleeping sickness our very you know everything would be all the stops would be pulled out most Larry I had less attention because it was the perfect mouth Susie in instrument you would hold the the children and keep it steady population. But as you grew older you develop a kind of clinical immunity. And you've got an adult that was able to pursue the low technology agriculture build roads or act in service ways that the Colonial it all sorts of ways. So in a way it had less attention and the colonialists you know the white settlers the Europeans and the Americans always had their quiet eye to at least save their lives.

It's it's almost like the levee has always been sort of a morality place to me. It's unique in that way. We have a number of calls now in fact the lines are full. We will get on to some of the callers here and I believe the next in line. Again someone on the cell phone calling from I believe than northern Illinois. Line number four. Hello good morning. Yes good morning. You know when I was in Vietnam I took my little area to it every day and they came back to the states and went to give blood they said they wouldn't take it from me. Do you know what it means. Yes. And they said it was because they'd been thinking that no it's not because you take a pill. It may have been that because the pill the drug had had long disappeared by that time. But there is the possibility there is one kind of malaria plasmodium mole Larry II. It's a cotton one. And that the allies around the lice or the

dog go in the blood come semi immune to it can be as long as 50 years and there is always the possibility of transfusions malaria so they were erring are on the very cautious side that we could never get. You probably can't I can't be there. OK just to add. Well thank you. All right thank you let's go to Champagne County. Call line number 1 Hello. Hi. You didn't answer the question about racism very directly but I think you illustrated Actually I don't want to be too confrontational but I'm rather disgusted to know Malthus does not say that people die from malaria. People die from malaria because of all sorts of reasons I mean the hidden hand of Malthus I haven't heard that one in a while and I respect your work over the years but prescribing DDT for another

country you know if you tried to do something spring like that around here I mean it's when we had the West Nile there are huge battles about spraying for mosquitoes in the south and this area and other areas. You know and I want to go back to the question I was going to ask because it's a little flustered about the Mall the mall so this is true actually the attitudes. Well I'm sure it's I was right. I don't deny the attitude but I have a cavalier about not condemning it you just. Well I like that it was a morality play. Oh it's fine it's fine for the call you know you were critical of them saying they have the quinine which is grown in the area from a bark of a tree in the area and keep it to themselves right. OK I just I'm looking for a little more outrage about it but. OK not afraid to say that. So but anyway. What about a vaccination that seems like a better place a less ecologically damaging and it's also

affected by the same way we are since we're not suffering from it the pharmaceutical industry isn't going to spend any money about it. But along with that. I have a story that's probably apocryphal but a long time ago a research assistant here told me that he had worked under a fellow and I believe the guy's name was Silverman. Oh yeah. And he said that they had a remedy for vaccination and our strategy towards getting there and this was this was in the early 70s. And then he's in a. Well you seem to know about the story so I guess I'll finish my telling of that as the way I heard it. And then I'd like for you to just comment you know specifically on the idea of why you know spread pollinate pala chlorinated hydrocarbons through the environment when you can vaccinate. But he told me that he had approached the Indian government and Gandhi was and and he said that he would not. I guess this gets back to mountainous in the way he would not proceed on the research and share it with Indian scientists unless

she instituted some kind of major family planning. Procedure you know policies and I don't know if you know anything about that specific story but just stuck with me all this time because you know this is years and years ago and it seems like he had a glimmer of an idea. Maybe he was totally wrong or maybe the story's not right either but why not a vaccination. I don't I don't know if we're into the vaccination segment where you can go I mean that is one of the questions that I want to talk about so we can go and talk about that you are right. They they have been pursuing vaccines for 90 years now and and they are I mean they were evaluating it honestly nobody's doing it right. There is no right. That's the problem we've been. My feeling my belief is.

That we may have a short term vaccine for so is fighting in in somewhere in some tropical countries. It's as bad as that Noah Terry remedy. But the vaccine I think we I think is being sold as a bill of goods right now. Maxine that's that has just received such great press attention it really doesn't work. It's it's not been effective and there's a large body of malaria researchers who are rather appalled by the high speed given has been gifted. There is just no vaccine. There may well be and never be a vaccine. And there it's not obviate the

other uses which are more difficult the getting of proper chemotherapeutic getting the proper insects to eat and impregnated mosquito nets into the population. The We've spent hundreds of millions of dollars and still the Gates Foundation which has given with the generosity that is has not been there since the Rockefeller days have been taken into this. There's a group that feels very strongly that. The vaccine the vaccine pursuit may be doing more damage than it we can good. But there is no vaccine.

Do you have an illustrated any reason why it's theoretically impossible you just this is again going Michael we want it's our only what in my 45 like is it's to begin to begin with. We don't know really what causes the natural immunity or the the semi immunity that humans have. It's not like a bacterial. The other thing is that a bacteria is a bacteria is a bacteria. Malaria parasite is for is so wide free of richness of the richness of the Americas. I go on. Well let me let me interrupt again. It is going over here. I mean a lot of let's not call it a vaccine let's call it finding out what that natural immunity is and trying to find out a way of enhancing it. I mean that's not a vaccination that's not a but it is an inoculation that would would impart

resistance now that maybe that is that is that a better formula approach that that may be that may well be to reduce morbidity and mortality is probably a more realistic goal. We'll probably never have a a vaccine that confers a sterile immunity as a bacterial or viral vaccine will do. But. The concern is that while there are other things. Well there are other avenues. The great effort is the hundreds of million dollars to be put in a vaccine research and this is not new it's been going on for the 90 he is and will continue possibly for nothing 90 years.

So there were others who are prophetic and say it's the only game in town. Oh I'm sure the research will go forward. We all wish them well. We're a bit past our midpoint here we have about 20 minutes left we have some other callers waiting and I do want to introduce Again our guest Robert decimates he is emeritus professor of tropical medicine and medical microbiology at University of Hawaii and has done a lot of research over his life on tropical disease in countries including Nigeria Singapore Thailand Hawaii. He is member of the World Health Organization expert committee on parasitic diseases has served as consultant to a number of governments including Burma Fiji Sri Lanka Bangladesh Thailand India and Tanga. He has written a number of books the malaria capers more tales of parasites and people research and reality published by WW Norton in 1901 and then another book that deals in a more general way with a number of tropical diseases. That book who gave painted to the Santa Maria that was

published by Norton in 1907 and is in part deals with the issue of syphilis and where it came from and how it was spread that's what the title refers to here. Questions are welcome 3 3 3 9 4 5 5 toll free 800 to 2 2 9 4 5 5 monogrammed to another caller and this time. The callers in Urbana line too. Well I think you know the board and I have had recently read about a pesticide roundup. I don't know that but of course and one that humans can ingest and it's actually non Cox It's human because they don't have the metabolism to to actually get to the toxic metabolites. And this is the fact of against malaria but that research is being held up because of patent issues I want to thank you. If you know about this or. No no I don't have it now you know. You know they're in a lot of patent

issues. But you haven't heard about Asians around you know I have I have no idea. I've not heard but also certainly looked into it and curious you know like the pills we give to our cats the syntax. Yes. OK thank you horrid thing. All right well does that I mean this this maybe a little bit out of your line but does that seem like a reasonable Avenue. It sounds as if the idea would be that the person would take take in the insecticide. It would theoretically not harm them but then if a mosquito bit them then the mosquito would die as a result. We do it for a lot of animals including It's a we we just forced the pill down catch a couple of days ago hadn't these systemic in effect the side seems to be effective. I I would

I would I would think the possible danger is and no lawsuits would be such that most develop is would be very very hesitant or reluctant to apply for that. That's my that would be my take on it as well. What they're using mostly like trying to use now or to push though it is. Miskito nets that are impregnated with these long lasting high wreath and the rabbit is Tyree Royds and they act as if the pellet in the claim is not everybody is is agrees with that but the claim is that where it's been used they reduced malaria

mortality by about 30 40 percent. Let's talk with another caller this is also someone in Urbana line number three. Hello good morning. Malaria has almost been written out of the local history. I was on another project and got involved with the memoir of a Dr. Charles Brown Ulan Johnson who practiced locally in Champaign County he came here in 71 and his autobiography knows that in the summer of 72 the area this region experienced an laugh in Demick it's his word of malarial fever in central Illinois. And he said within the bounds of my practice which was Southern Champaign County I think almost no one escaped an attack. And the other thread is the very important issue of drainage that the state legislature inadvertently in 1880 when they passed the drainage

laws that enabled farmers to organize drainage districts and effectively lower the. Probably the the water table in the across the county about 10 feet dried up all of these perennial swampy areas and so on that that was the beginning of the end for malarial fever is here. And I just wanted to comment that on the one hand until this county was they began to settle in the 1830s and you have to see this disease as really a hindrance upon the occupation of this whole Grand Prairie region. And then after 1880 part of the energy that comes from the industrial developments real roads and so on. Musta been supplemented augmented in some way by the fact that effectively drainage although they didn't associate this with some of the mosquitoes that were causing the

problems enabled people to basically survive two or three bad months in late summer. Without you know we're healthier and more and with more strength and the ability to do the ordinary task. And that was my comment simply. All right well Dr. Jeff would respond anyway. Well a couple peripheral ways as usual. That's true. Malaria the malaria mosquitoes was distributed virtually all through the United States in the north the northern tier where Illinois hit that area even in New York. You would most likely you would be getting plasmodium by Max which is very debilitating. But it doesn't cause any deaths. Nevertheless it caused the anemia and the debilitation and the

malaria would be it's just at the spring planting season so it had a tremendous amount of economic effect all through that part of the United States maybe even well it had some cognitive effect on the ability of children. To learn but you talk about the drying out this is what the TVA says he did in the Tennessee Valley. They were smart enough to know where the the water levels but the comment that we want to make is there are about 50 or 70 and not saline species that act biologically as a as a malaria vaccine or carry malaria and each one of those has a very specific and different kind of behavior particularly in breeding and

biting. Some will breed in wide open waters exclusively. Others will breed in very small collections of waters. So it's not one mosquito it's many mosquitoes. And that's where you get. You have to have a strategy that deal with the mosquito vector with the cube region. Well again I hope it gets at the the caller's question we have about 15 minutes left in this part of focus 580 And again our guest is Robert desolate. He is an expert on tropical diseases Emeritus Professor of tropical medicine and medical microbiology at University of Hawaii and has written on this subject including his book published back in 1991 specifically about malaria. Our topic here the malaria capers more tales of parasites and people researching reality again published by Norton just to go back

to the subject that we had a caller call in about. Raising this question about whether it is possible that somehow a product could we developed similar to the kind of things that we give our cats and dogs some kind of oral product that they can take that will fight off disease carrying insects. The caller made reference in her comments to round up and one of our agricultural reporters Todd Gleason was listening and he called to point out first of all quite correctly that Roundup is a herbicide it's a weed killer it's not an insecticide and he's seems to be saying that as far as he knows that insecticides are very toxic and potentially harmful to human beings and if you take in enough of them if you ingest them they will likely kill you. Herbicides not quite so problematic but but that wouldn't be that wouldn't have the desired effect. So maybe that's something we can investigate a little bit further about that we just wanted to put that information out there. Obviously people should be very careful when handling these chemicals. Follow the directions and keep in mind the fact that there are potentially

harmful. Right. Let us go here we go somebody else champagne line number one. Hello. Yes. Yeah I don't know maybe I've missed this discussion at the beginning of the hour when I wasn't listening but what is the relationship between fighting malaria and TB and the HIV virus. Have you discussed that yet. It seems like that's a very complicated issue is it not. I begin. This is not probably the common kind of thought on this. I really don't think so for several reasons but the main one unlike TB and its levy the HIV. Well Larry it is eminently treatable. Nobody has to die of malaria have the ability to

buy the drugs to get the drugs to get pure drugs you know. They have a wonderful drug now which is originated mostly in China and the missin and that's being counterfeited 90 percent of it. I think Cambodia is counterfeit but if it's there we we could deal with malaria. Given If we say the countries affected countries will really overcome their administrative difficulties their financial difficulties. But it's not like HIV and nothing like a good deal of tuberculosis which is a good drug resistant now but the other thing is of course that makes malaria unique to you. It is

transmitted by mosquitoes specific mosquitoes so you have two arms of attacks both in the humans and against the mosquito vector as well. So if someone is weakened by TB or HIV that doesn't affect their progress at Area are. It doesn't seem to or there's a few studies from Africa that would indicate that they may be. That malaria may be slightly more fulminant but we're not seeing the overwhelming mutant depressions against malaria that we expected in the AIDS patients. We're beginning to see it beginning to see a little bit of malaria pregnancy in the HIV as being possibly.

More Foreman and you know malaria not only killed children usually under the age of five but it's a disease of pregnancy usually reasons that mature during the first pregnancy as well. Well you were saying that administrated in financial issues that are not properly managed has malaria not to be addressed. How does that go along with problems with addressing issues of HIV and Keithy. You have you have an attack. It's simple it's probably in its simplest chemotherapeutic for me you have an attack of malaria and you know it's malaria. You know there is nothing quite like it. And people go to their aid stations or the hospitals or even the local pharmacy and they

buy ineffective therapy and they take it in a scribe fashion. And the attack is over until the next time. With that may Chivey you're taking thousands of dollars worth of drugs that is trying to suppress it. But there's never any cure so far at least. And it's a it's a it's just a completely different. OK. Well but I maybe I had to ask. I know that TB and HIV have been sort of associated problematic I guess I had thought that malaria within that circle of issues that if it's a cause of the great neglected diseases because there are diseases right now where the large repository of it the great difficulty is in the third world

particularly in Africa. So it's a kind of triad of death but the approach to solving the problem of them is it is different I think for each one of those disease. We just care in life shouldn't lump them together. OK well that's very interesting. Thank you Noah. Thanks for the CO. You talked about the fact and I'm I think people often refer to malaria as being a tropical disease and you said well it's not really a tropical disease at least here in the United States you said there was a time that it had been found as far north as Maine which we don't particularly think of as tropical. Is there some concern do you think that there's reason for concern that if we if we have some of the climate change scenarios that some people are suggesting aware that temperatures are going to warm that we

might see more problems with something like malaria here in the United States because the because they would be more territory that would be hospitable for the mosquitoes that carry the disease. I don't think so I think here in the United States we would never allow the infection to get a foothold again. Are our treatment network our rep of epidemiological where it is is such that. He would never get the foothold that it did in the late 80s late 19th and early 20th centuries. The weather global warming will affect malaria AIDS is being debated in several meetings on this. And what is certainly happening is that in the tropics where they have the mountainous tropics malaria is

going up the mountain as has climate changes and warms up so there are communities peripherally that have me under attack that hadn't been before. I I I I don't know. Global warming if it warms you may get a temperature change sufficiently to get more of the Plasmodium falciparum part which is the full method of malaria and needs a high of temperature so that would probably be a possible danger. I don't think what the Western world should have any great fear. Well Larry and global warming. Just my take on it. Just to touch once again for anybody who might not have been listening because this was one of the reasons that we said we thought

it would be interesting just to talk a little bit about in basic terms about the disease again. People might have heard this was maybe back air earlier in the fall about their head there were some tests. There was a large vaccine trial in Africa that was funded by the Gates Foundation it was the biggest trial that had ever been done at least that's what it said in the stories that I had read and that while it was not a complete success there was some partial success on the news on this was very optimistic and you said you thought well perhaps it was a little bit too optimistic and that you were doubtful about the possibility that any time. Soon there would be a vaccine although you would expect that the research on vaccine would continue at least as long as there were people who were willing to fund it. It is that isn't really the case a fair to say that you you don't ever expect to see a vaccine for malaria. In my heart of hearts I think I don't expect to see a vaccine and effective vaccine that could be deployed.

TO AFRICA. I think you may have a short term vaccine that could be used in troops going to indebt make areas for short periods. Hi hi. I think malaria is not one of those diseases like the common cold that's going to respond. But best of luck to you know we all we all wish them well and. I was one of the early. Support is returning to vaccine research. Paul Silva MIT was one of the first. Back in 1972 its use a United States Agency for International Development. As for his work but we really don't have an I I can't I had it we don't have time to go into the numbers now and for the

analyses. But there are some very distinguished malaria research is re-examined as it figures from Mozambique and feel that it was overstated. Well we will have to stop there because we've used our time a doctoress whites only Thank you very much for being with us today we appreciate it. Thanks much I've enjoyed it. Our guest Robert Emeritus Professor of tropical medicine and medical microbiology at University of Hawaii author of the book the malaria capers and also who gave Pinta to the Santa Maria. If you're interested in reading about the subject of tropical disease.