By Ify Aniebo
I lost my best friend to malaria at nine years old. Growing up in Nigeria, it was not uncommon to see loved ones fall ill with the disease, go to their doctor for treatment and continue on with their lives. But for my best friend, the drugs didn’t work.
Her death was a puzzle that motivated me to focus my career on malaria research. Through my studies and work, I’ve learned about one potential cause of my friend’s death, a remaining challenge in the malaria fight today: drug resistance.
Drug resistance occurs when the malaria parasite learns to outsmart our best treatments. We’ve seen its damaging effects before – notably, with chloroquine, the malaria treatment of choice in the 1950s.
After heavy chloroquine use across the globe, resistance developed in Southeast Asia, and then spread to nearly all malaria-endemic areas, leading to dramatic increases in malaria deaths.
Now, we again have evidence of drug resistance in Southeast Asia – this time, to artemisinin, our most effective malaria drug. Artemisinin-based treatments – along with mosquito control, new diagnostics and other tools – have transformed the fight against malaria and helped drive a 60 percent reduction in malaria deaths since 2000.
Yet resistance threatens the power of these treatments to save lives in the future. If these parasites move from Asia to Africa, where 90 per cent of malaria deaths occur, we will lose the great gains that have been made in preventing infections and deaths from this disease.
This doesn’t have to happen. As a master’s student at Oxford University and later as a Ph.D student focused on identifying and tracking drug resistance in the laboratory, I have seen the power of scientific research to solve problems.
Through research, we can prepare to monitor, contain and treat artemisinin-resistant malaria.
Cutting-edge surveillance techniques can keep us one step ahead of the parasite. Targeted control programmes using timely data can ensure that effective interventions reach those who need them. Drug discoveries can produce the next class of lifesaving treatments.
Scientists around the world are creating tools to fight malaria on the African continent, but my vision is that these discoveries will be developed in Africa, by Africans.
For example, Nigerian scientists know the problems their country faces and are best positioned to craft solutions. We can lead the fight against drug-resistant malaria where malaria matters most.
Opportunity: This opportunity is personal for me: as a scientist, I would like to return home to Nigeria for work, but for now – unfortunately – the best opportunities for me are in the United Kingdom and this shouldn’t be the case.
To achieve this vision, we must empower scientists across the continent to solve pressing challenges with homegrown, sustainable solutions. This will require key investments and actions from international donors and domestic governments.
First, we need people – more trained researchers to tackle the toughest problems in their own countries. I know the benefits of investing in future scientists because I have experienced them myself.
Scholarship: My scholarship to Oxford University, supported by the ExxonMobil Foundation, allowed me to advance my research skills and knowledge of malaria, leading me on the path to my Ph.D. Such programmes offer a model for encouraging young Africans to pursue careers in science and equipping them with skills to lead in their countries.
Second, our scientists need tools. Researchers must have the proper equipment – including scientific instruments, laboratory space, and electricity access – to conduct their work.
Donors should prioritize these needs in the grant making process, following the example of investments made in the Kenya Medical Research Institute, home to accredited, state-of-the-art laboratories.
Other countries must also address their gaps in scientific infrastructure, with financial assistance from international groups.
Finally, for these investments to have an impact, countries need to consistently adhere to science-based policies for malaria control.
For drug-resistant malaria, this means national projects to monitor, contain and manage the threat, saving millions of lives from potential treatment failure. African countries can take inspiration from Cambodia’s Village Malaria Workers Programme, which deploys community health workers to provide directly observed screening and treatment for malaria in containment zones, as a government-coordinated strategy to prevent the spread of drug resistance.
My best friend’s death remains a puzzle to me, but this World Malaria Day, I am more confident than ever that African scientists, working in their home countries, can tackle artemisinin resistance. If we make the needed investments, we can ensure that no young child loses their best friend to drug-resistant malaria in the future.
Ify Aniebo is a molecular geneticist, focusing on malaria drug resistance, at the London School of Hygiene and Tropical Medicine.