A physician at the front lines of the malaria fight
Dr Fred Binka
Coordinator of the Mekong Malaria Elimination Project
How did you first get involved in the malaria fight?
Malaria has always been a part of my life. I grew up in the Northern region in Ghana and every March the rainy season would come, creating pools of standing water that were perfect breeding grounds for the mosquitoes that spread malaria. People would get hundreds of mosquito bites every year and the malaria burden was terrible. My father used to give us quinine every Sunday to try to prevent us from getting sick, but each of us still had many bouts of the disease.
When I first started out as a young physician in the early 80s, the problem remained very serious. At that time, more than half of the people I saw at the clinic had malaria, and many died before I could treat them. It was at that time I began to get involved in clinical trials research. I worked with other scientists to investigate simple tools and preventative measures that would help reduce the burden of malaria.
Can you talk a little about how you’ve seen the malaria community evolve over the last 20 years?
The late 90s was a very interesting time to be in the malaria space. Other health issues were receiving a lot of attention, but few people were focusing on malaria. And many people living in endemic countries thought that malaria was just a way of life: getting infected was inevitable, and then you would either survive or not. But malaria is of course preventable and treatable, and we had a chance to start to change that mindset. We now know that time was the beginning of a huge groundswell of support for the malaria fight that has continued until today.
Getting to where we are now was a huge challenge, and I did not anticipate the level of progress we’ve seen. It’s been incredible to see malaria mortality steadily decrease and people live healthier, happier lives.
What are some of the key areas the global malaria community should focus on over the next five years?
It’s been incredible to see malaria mortality steadily decrease and people live healthier, happier lives.
Dr Fred Binka
We must continue to develop new tools that will allow us to fight the disease more effectively. First, we have good treatment, but some people will stop taking the drugs once they start feeling better even though they have not finished the full course of treatment. This can cause the disease to come back and it can contribute to the malaria parasite’s growing resistance to our best drugs. So the development of a one dose treatment for malaria will really revolutionize the field.
Second, we need to develop a better strategy to address the decreasing effectiveness of insecticides. Third, strong surveillance and measurement are critical. And fourth, we need more sensitive diagnostic tools, especially in areas where there tend to be more people that are asymptomatic carriers of the disease. Focusing on asymptomatic carriers will be increasingly important in areas of low malaria transmission. If we have these tools and our health systems are strong, we can continue to make a huge dent in malaria transmission and begin to eliminate it in target areas.
What is one of the biggest challenges the malaria community faces in the near future?
I want to emphasize the fact that the progress we are making could actually be our downfall. What do I mean by that? Countries have done a great job decreasing malaria cases and deaths, but we’re not out of the woods yet. Until malaria transmission has stopped, there is always the risk of resurgence and losing all of the progress we have made.
So we must not let these accomplishments trick us into thinking that we can let up our efforts before the job has been finished. The costs of fighting malaria will actually go up until the disease has been eliminated. This can be a very difficult point to make, but it is critically important: Funding and new research to fight malaria must remain a key priority until transmission of the disease has completely stopped. This must be our goal.