Creating Chemistry for a Sustainable Future Issue One 2012
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Creating Chemistry For a sustainable future Issue one 2012 Malaria: Also in this issue: 6 How Gary White and Matt Damon are A winnable war? realizing their vision of clean water for all. United Nations advisor Jeffrey 28 Scientific advance or aberration? Two experts Sachs explains why malaria make the case for and against plant biotechnology. control is a battle worth fighting. Interview page 14 36 Mission impossible? Mitigating the impact of the global freight boom. 50 Driving into the future: What’s next for our love affair with cars? 58 Conductor Gustavo Dudamel explains what he wishes he had known when he was younger. Malaria: The issue Fighting the war on malaria Malaria kills 780,000 people every year – most of them in Africa. Its effects have trapped millions in an endless cycle of poverty, but thanks to a massive international push to control the disease, it may finally be losing its grip. Could this be the beginning of the end for malaria? 8 | Creating Chemistry Creating Chemistry | 9 Malaria: The issue he statistics may appear Percentage of with 73 million people in Africa protected bleak: Every 45 seconds 20% households owning at from malaria with IRS programs, up a child dies of malaria Malaria causes 20% of all least one insecticide- from 13 million in 2005. and over 780,000 people childhood deaths in Africa. treated net, 2010 The last decade has also seen the in total die from the (Source: UNICEF global arrival of larvicides, a new generation malaria databases 2011) disease every year. Yet Burundi Malawi Zambia Niger Mali of anti-malarial drugs, and Rapid compared with two years ago – when it Diagnostic Tests, which enable earlier T 85% 85% 76% was estimated that a child died of malaria 60% diagnosis and more accurate treatment. 64% every 30 seconds, with nearly one million 85% of all malaria deaths occur 52% The distribution of these technologies in children under the age of five. total fatalities worldwide – those figures together with better case management offer some hope. and education has delivered positive The truth is, cases of malaria are falling results. Eleven African countries have – thanks to what is arguably the most 40% reported a decrease of at least 50% in organized collective campaign against Malaria accounts for approximately malaria cases between 2000 and 2009. the disease the world has ever seen. 40% of public health spending By 2009, the annual number of malaria Since the late 1990s, efforts to reduce in sub-Saharan Africa, 20% to deaths had fallen by 20% in comparison 50% of inpatient admissions and the malaria burden have been gathering 50% of outpatient admissions. with the beginning of the millennium. In pace, with public health organizations, 2010, Morocco and Turkmenistan were aid agencies, governments and private certified by the Director-General of enterprises combining their resources. WHO as having eliminated malaria. This is organized through a set of new 4.2 million inter-agency partnerships and initiatives It is estimated that 4.2 million A challenging future that include the Global Fund to Fight lives would be saved by full In other words, the push to reduce malaria coverage of malaria control AIDS, Tuberculosis and Malaria, as well measures – i.e. use of nets, cases is working – but there are still as the President’s Malaria Initiative in the spraying, diagnosis, drugs – plenty of challenges ahead. Of particular United States, and Roll Back Malaria. by 2015 in the 20 most at-risk concern is the distribution of nets. Roll The collective effort is focused on African countries. Back Malaria estimates that 100 million achieving U.N. Millennium Development LLINs must be financed and distributed Goals (MDGs) – one of which is to halt globally every year, to sustain coverage and begin to reverse the incidence of and replace worn-out nets. But with malaria and other major diseases by Below Pregnant women and distribution bottlenecks still an issue in 2015. The Roll Back Malaria partnership children are the most vulnerable some countries, this is proving difficult to has taken this still further with a goal of to malaria. It contributes to the achieve – as is the organization of IRS. deaths of an estimated 10,000 near-zero deaths from malaria by 2015 A resurgence in cases has been pregnant women and up to – with the ultimate aim of eradicating 200,000 infants each year observed in parts of at least three African malaria altogether. in Africa alone. countries: Rwanda, Sao Tome and Principe, and Zambia. The reasons for this are uncertain, but one possible cause is a relaxation of control efforts; in Sao Tome and Principe, the resurgences followed a year in which IRS wasn’t deployed, for example. There is also the ever-looming threat of resistance to commonly-used insecticides, and drug resistance. In Cambodia, artemisinin-based drugs Left The distribution – currently hoped to be the most of insecticide-treated nets effective form of malaria treatment – is central to malaria control are now taking longer to take effect. strategy: These nets have been shown to reduce It’s unclear as to why, but it was in the malaria transmission by 90%. same region that resistance developed to the older antimalarial drugs So why malaria – and why now? chloroquine and mefloquine. These challenges cannot be The poverty connection endemic poverty in many countries. of the malaria burden: Around 90% of (LLIN). Lasting at least three years, addressed unless the global community Unlike other deadly diseases, malaria This isn’t the first time the world has all malaria cases occur in Africa. these nets have been shown to lower sustains its investment and interest in the is both curable and preventable. tried to stop malaria. In 1955, the World Critics are quick to question why, transmission by 90%, malaria incidence 2015 goal. There is now growing concern Research has also demonstrated Health Organization (WHO) submitted if eradication didn’t work in the 1950s, by 50%, and child mortality by 15%. that the campaign may fall victim to its that the economic and social effects an ambitious proposal for the eradication it will work now. But much has changed: Over the last few years, there has own success: As the burden of disease of malaria are devastating. Malaria of malaria worldwide. Some countries Advances in public health knowledge, been a massive international push to falls away, political resolve could weaken keeps children away from school and managed it; others were less successful, treatment and technology have allowed deliver these nets: WHO has reported and financial commitments diminish. adults from work; it pulls families into with initial reductions followed by sharp the development of coherent and that 289 million nets were delivered Given the current global recession there poverty and keeps them there. increases once efforts ceased. effective malaria control strategies, to sub-Saharan Africa between 2008 is a genuine fear that malaria control Predictably, its greatest impact is on Climate apparently made the as set out by WHO and in the Global and 2010. That is enough to cover could move down the list of development the world’s poorest – those who simply difference between success and failure: Malaria Action Plan. 76% of the population at risk. priorities. And yet there is hope: Only cannot afford treatment or who have In temperate countries where malaria is Indoor residual spraying (IRS) – recently the U.K. government announced limited access to healthcare. Overall, a seasonal disease, eradication was Getting results where walls are sprayed with insecticide it would be increasing its investment malaria causes an average loss of 1.3% possible. Not so for countries where The last decade has also seen a series of – has also been shown to reduce in the malaria campaign, for example. of annual economic growth in countries malaria is rife all year round. The climate innovations that make fulfillment of the transmission, and WHO recommends If the global community manages to with high transmission rates. Tackle factor at least partly explains why it is 2015 goal achievable. The first of these it be used in tandem with LLINs. Here sustain momentum, the eradication of malaria and you go a long way to tackling sub-Saharan Africa that bears the brunt Above Innovations in medicine and technology are allowing earlier diagnosis and more accurate treatment. is the long-lasting insecticide-treated net again, distribution has been impressive, malaria could be a distinct possibility. 10 | Creating Chemistry Creating Chemistry | 11 Malaria: The issue Illustration by The Grundy Peter malaria cycle How malaria spreads – the cycle of infection Malaria is a disease caused by a parasite called Plasmodium. It is transmitted exclusively through 1 Infected mosquito 2 Parasite reaches liver 5 Infected red blood cells burst, the bites of female Anopheles mosquitoes. When bites human. in just 30 minutes. releasing parasites which an infected mosquito bites a human, the parasites then infect other blood cells. enter the blood. Within 30 minutes they infect the liver. Between six and nine days later, the parasites leave the liver and enter the bloodstream where they invade red blood cells. As the parasites multiply, the red blood cells burst, releasing thousands more parasites into the bloodstream where they infect other blood cells. It is at this point that the person 4 Parasite enters blood will suffer from high fever, chills, nausea and anemia. stream, attaches to When another mosquito bites the infected human, and invades red the parasite is transferred to that mosquito. While blood cells. Further in the second mosquito, the malaria parasite goes reproduction occurs. through several stages of growth, which takes between 10 and 21 days, depending on the parasite species and the temperature.