Plasmodium, the malaria parasite, is a single-celled organism of unparalleled resilience.
For the past seven months I’ve studied malaria thanks to a grant from the Wellcome Trust to write a book about it. The research has taken me to many laboratories, inside countless articles, into conversations with brilliant malariologists, behind many lenses and to many places – including to the border of Thailand and Myanmar where NPR recently went for their story “A View From The Ground: Thailand Confronts Drug-Resistant Malaria.” While their video below is important, exceptionally well-done and addresses many of the issues regarding resistance, it also served as the final push for me to write about what I can only describe as an exorbitant amount of “victim-blaming.”
When malaria and resistance are presented in public articles there is often a subtle tone coming through that whispers: there are wealthy people trying to help and then there are the poor idiots who screw it all up.
I had lunch one day at the Thai-Myanmar border with Dr. Paul Newton. The guy is a total rockstar when it comes to malaria drug-resistance. In fact, that morning he was featured in a BBC article on the topic. He’s also unbelievably humble and honest. There I was with my notebook ready and willing to probe the brain of this legend with questions about where the counterfeit drugs come from, how to respectfully educate the local people to stop believing that malaria is a curse or that homemade remedies should be taken instead, when he looked up at me and said: “It just happens. Resistance. This is just what happens.”
He eventually answered my questions, but those were the words that stuck with me most and the words that fueled a considerable portion of my research into the topic. Those words were confirmed about a million times by other researchers and even in the sense of fatigue I felt from those working to combat malaria. This killer just keeps finding ways to kill and it doesn’t take long before some new drug comes and does well and then… “it just happens.”
Yes, those in malaria-infested areas and stricken with malaria do things they shouldn’t. Yes, there are so many groups profiting by making drugs with too few ingredients and these drugs are increasing the pace of resistance. But the core reason we’re still talking about malaria in 2012 and will be for years to come is that it fights back against everything we’ve ever thrown at it: DDT, Quinine, Chloroquine, Mefloquine, Artemisin-based combination therapies and more. New research is proving that in some places the mosquito that carries the Plasmodium parasite has not only become resistant to the insecticide on the bed nets, but they’re actually feeding earlier because they’ve adapted to how most people use the nets at nighttime.
Private language almost always differs from public language, but I found this exceptionally true in regards to malaria. Here’s NPR’s insightful video. It’s certainly worth a watch but please do keep some of the above in mind.
–Photo: Muhammed Muheisen, AP
Evolution, not victim blaming, is the reason that we get drug resistance. Even if drugs are used perfectly parasites will evolve resistance genes. Counterfeit drugs with less active ingredient speed the process, but it is still inevitable. Also, it isn’t talked about much, but pouring petrol into lakes and swamps kills the mosquitoes, and was used to eradicate malaria in the US in the 1950’s. The problem is that there are serious environmental side effects, and the country has to be developed enough to actually pour petrol into all of it’s swamps, lakes and rivers. Also in Africa all of… Read more »