SUSTAINABLE DEVELOPMENT MALARIA GROUP

Transcription

1 PROJECT REPORT 8TH APRIL 2005 SUSTAINABLE DEVELOPMENT MALARIA GROUP TORA OLSSON TABLE OF CONTENT Introduction p.3 Method... p.4 Evaluation of sources. p.5 Results p.5 List of sources p.6 Appendix: Project plan.. p.8 INTRODUCTION Malaria is a part of daily life for millions of men, women and, perhaps most importantly, children in Sub-Saharan Africa. Despite the fact that the Plasmodium parasite kills people per year in Zambia alone, the problem is to a large extent overshadowed by HIV/AIDS. Our investigation on this area therefore started with a general curiosity: How big is the problem, and why do we in the western world hear so little about it? Jacob Kjell, Hannah Lindberg and I started the malaria group in December 2003 and formulated the very first aims for a project which was to last for almost two years. Besides wanting to know all about the disease on a biological level as advanced as we possibly could, we decided to investigate current and upcoming as well as historical treatments; their cost and efficiency. We planned to be able to evaluate ongoing prevention projects and take a closer look at how insecticides and mosquito nets work in real life. Finally, our overall aim was always to spread greater awareness about malaria to the people around us, which is why we since day one have planned a seminar which is to be held on International Malaria Day; April, 25 th. Our original target group, westerners in general, has been narrowed down to students of Kungsholmens Gymnasium, however from both sections and lines. We are aware of the fact that our audience is most likely to have very different interests

2 as well as previous knowledge, and we therefore plan a seminar which, although with an emphasis on the biological aspect of the disease, is not strictly scientific. Parallel, and sometimes as a part of, our malaria research we have been planning and collecting money for a trip to Zambia which took place in February/March It was always our aim to, if we would get to go on the trip, interview students, teachers and a doctor or nurse to get a feeling for what malaria is to the people who live with it daily. Because of this, as well as the fact that 90% of all malaria cases occur there, we focused our pre-trip investigations on Sub-Saharan Africa. Thus, because of the expected audience as well as our study visit to Zambia, our project came to have a strong social as well as biological aspect. This was a - to some extent unexpected - bonus which we, perhaps naively, did not count on but which naturally follows when one studies the causes and effects of any disease. The conclusions about social aspects of malaria which we drew when reading about it here in Sweden, as well as when discussing it with the Zambians, has undoubtedly played an important role in our understanding of the disease, and will to a great extent be reflected in the seminar. Finally, we also had the original wish that if we would get to go on the trip to Zambia, we would make a photo exhibition together with the seminar. This idea has been modified several times but is still hopefully with the aid of other Zambia group members taking place on the 25 th of April. METHOD We realized early on that our topic was extremely broad and demanding. It therefore proved to be very good to be a group of three as this made it possible to divide up the workload and be able to, in total, cover a wide range of sub-topics. We decided to, as much as possible, work with the general information about the disease together, as that would require an initial understanding which we thought we could help each other with. Thus, after we had acquired a good background, each one of us went deeper into a specific sub-area, in broad terms; the past the present the future of malaria. With an emphasis on the specific treatments of each time period, our aim was to investigate them all and then together be able to get a broad picture of the problem of malaria. Understanding the past would be important for understanding the current problems (i.e. resistance) which would in their turn help being able to predict the future. Remembering the original aim of the umbrella group, we decided it would be impossible to reach a sustainable conclusion without taking the past, the present and the future into consideration. We have thus worked a lot together as a group, which has been very effective and not least stimulating. Being part of the Zambia group, with continuous meetings and possibilities for discussions as well as questions from other group members, has also made our work a lot more interesting and rewarding. Being interested in history, I chose the sub-topic which deals with the past of malaria. I was intrigued by the fact that the most effective drugs on the market today are, to a great extent, synthetic versions of traditional drugs which have been used and developed for hundreds of years. When dealing with this topic, I have been able to use information from other subjects such as History and English, and in November 2004 I wrote an essay (outside of project work) concerning the importance of malaria for the fall of the Roman Empire.

3 As it was already from an early stage clear that it would be hard to find a lot of specific information on the history of malaria in Zambia, I decided in my earlier research, conducted here at home, to get a more general picture of the history of the disease and its remedies. However, a meeting with traditional medicine men (and women) in Monze, Zambia, gave me the opportunity to ask about and even purchase some roots and barks used locally to treat malaria. I hope to be able to find out about any potential relationship between the bark and the Latin American Cinchona tree, from which quinine is extracted. For this, I have ed Dr. Chipeta. I also interviewed Dr. Shafik in Livingstone about this and was, among other things, told the true story about Livingstone s death. In conclusion, my part of the topic has held many surprises and interesting facts in store and I hope to be able to convey a selection of them to our audience. The idea is thus that our audience on the 25 th of April will first get the over-all history of the disease and some of its remedies, then be introduced to the current problems in Sub-Saharan Africa and finally get a scope of what will be done in the near future and what the aims are over a longer perspective, back again to a more world-wide plane. EVALUATION OF SOURCES Our use of the internet as a major source of information has made it important to think critically, to try to find reliable homepages and to compare information from the net with that from books and interviews. We early on established a contact with Dr. Andreas Heddini at the MIM (Multilateral Initiative on Malaria) secretariat, Stockholm University as well as with Professor Anders Björkman at Karolinska Institutet, Stockholm. Having met with Andreas Heddini twice and Anders Björkman once, we have been able to question them on unclear information as well as hear them speak about the work they are currently doing. Andreas Heddini also put us in contact with Dr. Chipeta who is working for MIM in Lusaka and from whom we have also been supplied with some specific information concerning Zambia. Besides articles on the internet, books have not been a major source of information, mainly because we have not found any which were especially relevant for our respective topics abut also due to the fact that we have already been overwhelmed with information from other already mentioned sources. In Zambia, we have spoken to students in Monze Boarding High School as well as in Hillcrest National Technical High School. I also took the opportunity to speak briefly with the family I was staying with in Monze as well as the neighbouring family. Last but not least, we visited a private clinic in Livingstone and talked to Dr. Shafik, an originally Egyptian doctor stationed in Zambia for the past ten years. This was especially interesting because as he was not Zambian himself, he could be objective and showed us the things the state has been doing in a not necessarily good light. This gave us a great insight into the current situation in Zambia and, although we have to remember to be critical also here he is a private doctor and thus in contact merely with one sector of the population, changed our previous opinions a lot.

4 RESULTS After having worked in the Zambia Group for almost two years I feel that our project has met its initial goals. We have not only learned a great deal about the biological as well as social aspects of malaria, but also developed the routine and habit of working in a group. Having had to push each other, compromise about differing ideas and discuss doubtable information has in my opinion made the project a lot more interesting than it would have been had I done it on my own. Thus, I am content with my project not merely because we have now reached the stage where we can answer all of our original questions, but also because I chose to work in a group, a decision I have never regretted during these years. We are now confident about the seminar and I believe we will be able to answer most potential questions. The trip to Zambia was meant to be not much more than a bonus, but for the work of our group it has been a lot more than that. Our project would certainly not have looked the way it does today, had it not been for the opportunity we had to see with our own eyes what malaria is and does to a nation. We have during the past two years had the opportunity to learn a great deal about a far too neglected disease, but also to see what Sustainable Development can mean, in real life. LIST OF SOURCES Articles from Magazines, Johnsson, Marguerite Malaria: It s Back Time International May 31, 1993 Menendez, Clara Malaria During Pregnancy: A Priority Area of Malaria Research and Control Parasitology Today Volume 11- Num Articles from the Internet Clarke, Tom Genes means drugs and vaccines 03 October l Crutcher, James M. & Hoffman, Stephen L. Malaria Medmicro Chapter 83 Desowitz, Robert S. The Malaria Capers (More Tales of Parasites and People, Research and Reality). W.W. Norton & Company, New York, Books, studies Herwig Jansen, Dr. F., ARTESUNATE and ARTEMETHER Towards the eradiction of Malaria?, 2002, Dafra Pharma ltd (Belgium) Bergmark, Matts, Lust och lidande Om droger på gott och ont, 1968, Natur och Kultur (Stockholm)

5 Beattie, Pauline and Renshaw, Melanie, Malaria Research Capacity in Africa, 1999, The Trustee of the Wellcome Trust (London) Internet Webpages African Malaria Network Trust Bill and Melinda Gates Foundation Brown University: Public Health Interventions Centers for Disease Control and Prevention Directory of the African Malaria Vaccine Testing Network European Vaccine Initiative The Global Fund International Federation of Pharmaceutical Manufactures Associations Kimball s Biology Pages The Lancet username: malarzamb password:vivillaka Malaria Foundation International Malaria Vaccine Initiative Medicines for Malaria Venture Multilateral Initiative on Malaria (MIM) Roll Back Malaria Swedish Malaria Network United States National Library of Medicine: Malaria Research Resources World Health Organization -Fact sheet: -Special Program for Training and Research in Tropical Disease: -Using DDT for Malaria Prevention: Interviews Anders Björkman- Professor of Infectous Disease at Karolinska Institutet anders.bjorkman@ks.se Andreas Heddini M.D., Ph. D. Secretariat Coordinator Multilateral Initiative on Malaria andreas.heddini@mim.su.se

6 Dr. Shafik Dr. Shafik Hospital, Livingstone, Zambia James Chipeta B.Sc.<HB>,MB ChB,PhD Senior Registrar/Honorary Lecturer University Teaching Hospital, Lusaka, Zambia PROJECT PLAN Topic: Malaria Aim: Our aim is to find out about treatments against Malaria which can be used in developing countries and to evaluate these treatments. Malaria kills a huge amount of people in Zambia every year and it is Africa which suffers the most from the disease (90%). Currently, there is more emphasis put on the problem of AIDS in Africa and we would like to spread awareness of the fact that Malaria is one of the worst and most fatal diseases in the world. General Questions (see individual parts for more): How does malaria/its treatments affect the human body from a biological point of view? Parasite life cycle Traditional treatments (quinine, artimisinine) Previous, existing and future treatments (DDT, chloroquine, vaccine?) Other means of preventing infection? Roll Back Malaria projects; spreading awareness as well as equipment (nets) Sustainable insecticide use DDT used with care? MIM; supporting local research groups Social problems; public fright for medicine and financial problems? (How to raise the money? How to organize the group work?) Methods (malaria project): Internet Books and articles from library (Stadsbiblioteket + KI) Interview with Andreas Heddini and possibly Anders Björkman Trip to Zambia; interviews with students at Hillcrest and the other school + Possibly interview with Dr. Thomas Sukwa in Ndola, Zambia? Final Product: Seminar for students in Kungsholmen s Gymnasium held on International Malaria Day, 25 th of April 2005, see time plan for details (collecting money):

7 Flea markets (Christmas market + indoors market at Skärholmen) Bake sales Hopefully Lucia celebrations Funding (group and individual) Time plan: Individual Log Books to be handed in all even weeks. Have part of project work preliminarily finished by Friday the 22 nd of October, definitely done before Autumn Holiday (Friday the 29 th of October). Including brief answers to our common research questions and first thoughts and comments about the individual questions (see individual plan for further details) The last questions, about the more practical work involving money-raising, will be dealt with in individual log books. No written draft will therefore be presented concerning this. Submit a First Draft preliminarily the 3 rd of December. Including more in-depth studies of our individual questions Hopefully also including the interview with Andreas Heddini, which will definitely be done before the Christmas vacation. TRIP? Interviews with normal people about malaria Talk to nurse in school, perhaps hospital visit? Possible interview with a Zambian researcher as mentioned above; Dr. Sukwa We re taking photos, which we will show during our presentation. Final product: The content and date will depend slightly on whether we get to go to Zambia or not. If not, we will be ready week 10, otherwise week 11 Short written summary handed in including answers to all general and individual questions (we want to emphasize the oral part of the final product but there might be sub-questions which will prove to be unimportant enough not to mention during the speech these will be in the written summary). Seminar during around one hour about the disease, our work and the trip. Photos shown during speech; Dia-projection or power point. Malaria Day 25th of April 2005: Hopefully we will be able to have out presentation once again, this time to really fulfill the aim that we had from the beginning; to spread awareness. The seminar will be open to whoever wants to come and will have the same structure as the previous point.

8 TORA: What is the general history of Malaria? Quinine and Artemisinine; when and where exactly were they discovered/developed? The disease in the west; how was it eradicated in Europe and how have we over the centuries contributed to the development of drugs/research on malaria? How come the old traditional remedies, synthesized into modern drugs, seem to be the most sustainable and effective cure for malaria? What, if anything, has been done in the past in Zambia up until now? Are there any specific roots or herbs used in Zambia and do these have any similarities to those used in other parts of the world? I believe it will be hard to find a lot of information on the history of malaria in Zambia specifically. Therefore I plan to get a more general picture of the history of the disease (for example the question of misuse of drugs resistance). The question I would like to focus mainly on is that of traditional remedies. Right now, I am not familiar with any old cures used in Zambia but I am certain that if we go, I could talk to the school nurse about this. I find it fascinating that the old methods used in China and South America have proven to be so far the most effective and best of medicines. For this question a trip would, as mentioned, be extremely valuable. However, I plan to do research on the subject before we go and I hope to get enough material even if we do not have the possibility to interview anyone on place in Zambia. In case we do not go, I will focus more on the general history of malaria but with a special emphasis on Sub-Saharan Africa. I believe these questions will neither be too much nor too little to work with and although I might not be able to go as deep as I would like to, I plan to get a good understanding of the disease mainly through its history and hopefully form this get a few ideas about what could and should be done in the future. I will follow the general time plan for dates etc.