OpenForum – a blog by the Health and Human Rights community

[Editor’s note: This is a guest post written by Danielle Brown.]

“There is more money put into baldness drugs than into malaria,” said Bill Gates at the annual Technology, Entertainment, Design conference. To underscore his point Gates released a jar full of mosquitoes into the crowd, stating, “there is no reason that only poor people should have this experience [malaria].” He quickly assured the audience that those particular mosquitoes were not carrying malaria.

For many, especially the poor, malaria is a reality and a daily threat to their lives. Gates’ presentation pointed to the fact that malaria has been eradicated in developed nations but remains a problem for many equatorial countries. Approximately half of the world’s population is at risk of malaria, and it remains the single greatest killer of children living in lower-income countries. In 2006 alone, there were 247 million cases of malaria and 880,000 deaths. For a disease that is preventable and curable, these numbers are far too high.

Gates also raised an important question: How do you stop a deadly disease that is spread by mosquitoes? His response for prevention includes insecticide-impregnated bed nets and indoor residual spraying using the insecticide dichloro-diphenyl-trichloroethane (DDT). The two, used in combination, can cut deaths from malaria by 50%.

Despite this potential, the global response to this question is defined in part by a debate over the safety of DDT, framed by the Stockholm Convention on Persistent Organic Compounds and by WHO guidelines regarding use of DDT. The Stockholm Convention outlines a plan for the long-term elimination of the production and use of DDT by 2020, while granting DDT an exemption for use in public health. This exemption is conditional on whether alternative insecticides that are as cheap and effective as DDT exist. However, such alternatives are not readily available. Read more

[Editor’s note: This is the first in a series of posts covering topics related to drug resistance, including causes, effects, what is being done to fight drug resistance, and what needs to be done to limit the harm caused by drug-resistant pathogens.]

The discovery of penicillin in 1928 was one of the greatest medical discoveries to date, and since their introduction, penicillin and other antibiotics have saved an incredible number of lives. Unfortunately, it didn’t take long for the bacteria to fight back.

The discovery of penicillin-resistant bacteria within a year of the first clinical use of the antibiotic would serve as a sign of things to come. Today, there are few (if any) widely used antimicrobial drugs that have not been rendered less effective by the emergence of resistant pathogen strains. The fast replication cycles of bacteria and viruses and the mistakes made by their replication machinery give these pathogens the ability to respond to and overcome drug pressures. With penicillin, for example, replication errors allowed some formerly penicillin-sensitive bacteria strains to evolve so that the targeted bacterial proteins no longer interact with the antibiotic. Other bacterial strains acquired new genes that allow them to produce proteins that degrade penicillin, rendering it ineffective and allowing these bacteria to survive.

Drug resistance continues to be a major obstacle in reducing the prevalence of the “big three” infectious diseases: HIV/AIDS, tuberculosis (TB), and malaria. The recent emergence of malaria strains resistant to artemisinin, one of the most effective anti-malarial drugs and sometimes the only drug that can effectively kill the deadly Plasmodium falciparum parasite, serves to highlight how troublesome — and downright frightening — drug resistance can be. Read more