Archive for the 'Heroes' Category

Lasker award to Dr Tu Youyou for the development of artemisinin therapy

 (image credit: Lasker Foundation)

Congratulations to Dr Tu Youyou for her well-deserved Lasker award (considered a precursor to the Nobel prize) in clinical sciences (hat tip: Mariam).

Dr Youyou recieved the honor for her painstaking work screening traditional Chinese herbs for antimalarial properties as part of military project 523 (more on the military and malaria here). The operation isolated Artemisia (also known as sweet wormwood) extracts, refined production, removed toxic elements, and conducted initial human trials which led to the development of the most potent antimalarial drug discovered to date. Artemisinin combination therapies are now the first-line treatment for Plasmodium falciparum in nearly all countries and cure millions of patients each year. The Lasker site includes a fantastic recount (much better than sparse biographies the Nobel committee posts) detailing this great story of scientific rigor applied to a rich knowledge heritage.

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Sujal Parikh Symposium on Health and Social Justice

The goal of this event is to honor the life of Sujal Parikh and to carry on his vision by bringing together a community to advance health and social justice. Themes for the symposium include curricula as an agent for social change, defining health equity, and innovations in global engagement.

Date: March 26th, 2011

Location: University of Michigan, Ann Arbor, MI

More information and get involved at: http://sujalsymposium.org/get-involved/

The deadline for free registration is March 12, 2009 – see you there.

Heroes: Sujal Parikh

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For teaching me about health, human rights, and life by your example

Here’s to you Sujal

Innovation in malaria case detection

The paradox of malaria and many tropical diseases is that those most at-risk are also some of the least likely to access, or be able to access, health facilities. Active case detection, the screening of fever cases in the community itself, helps enable case management in such remote or inaccessible areas. But it’s also time and manpower intensive. Answering the questions of where to target, and whom to target is critical to making sure that effort will be worthwhile. In practice, the usual mechanical application of the strategy ensures that it will not be efficient.

So it’s beautiful to see an example of creative thinking. Last year in the infamous Jalpaiguri district of India, I met an unique, young block medical officer. Over some hot milk tea, the clean-shaven late 20s year old commented on how most of the cases at his primary health center labored in the dense jungle along the Bhutanese border. Living in secluded villages, many sought care only after prolonged illness and often arrived with severe complications. In fact,  he had described a well known phenomenon. From central India to throughout Southeast Asia stretches a vast epidemiological belt of  ‘forest malaria’. The ecotype is notorious for intense transmission due to the efficient mosquito species (A. fluviatilis, minimus, and dirus) particular to that habitat.

How did he respond? Simply, intensify active case detection in those areas. To his surprise, few of the blood smears collected turned up malaria parasites. Why?  Slides were collected during the day, exactly when most of the workers were away. Undeterred, the medical officer led his staff to the villages at dusk when workers were back from the bush. Travelling as late as 8 and 9pm by unlighted, broken roads, they again returned the following day to treat infected patients. He knew it to be unsustainable for the health workers themselves in the long run, ideally the villages could receive  a community health worker (ASHA) or later they could train community volunteers, but continued the practice for the rest of the high transmission season. It paid off. Inpatient admissions for severe malaria at the primary health center fell dramatically.

I was floored. Here he was young, new to the area, no special training in malaria, but already making a difference with the few resources at his disposal. It is the value of good management. Best of all it’s not a story about new technology or glossy strategy guides – just careful observation and dedication.

Malaria heroes: Sir Rickard Christophers

From the Wellcome Trust
Image from the Wellcome Trust

This is the second post (first one) of my attempt at profiling different malaria workers. Not many have heard of the epidemiologist Rickard Christophers (1873 – 1978). I came across his work accidentally, which was fortunate, because his lessons hold great promise for our efforts today. Having worked in the Duars area of India (where Sir Rickard led a landmark two year malaria survey), his legacy and writings speak closely to me.

Some reasons why Sir Rickard is an all-star:

  • True malariologist – studied the host, vector, parasite, and social environment
  • Coined the concept of the ‘tropical aggregation of labour’
  • Fought for improved labor conditions of tea workers to reduce malaria
  • Chronicled the infamous malaria epidemic cycle of the Punjab
  • Founded the Malaria Reference Lab, later directed the Central Research Institute at Kausali (forerunner to the Malaria Institute of India, which became the National Institute for Communicable Diseases)
  • Worked past the age of 100

Some editorials about him:

Malaria heroes 1: Krongthong Thimasarn

Beyond the glitz and glamour of malaria advocacy on the world stage, there is a cadre of dedicated individuals that is working hard in malaria control everyday. Community volunteers, health services staff, researchers, control managers, and others may not appear in the papers, but their work is the basis for any progress achieved. I think it’s important to take some time and highlight a few people.

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My first post in this series is on Dr Krongthong Thimasarn, regional adviser for malaria at the  Southeast Asia Regional Office of the World Health Organization.

Highlights:

  • Former director of the Malaria Division at the Thai Ministry of Public Health, arguably the best malaria control program in the world
  • Founding member of ACTmalaria network – a collaborative training network for Asia
  • Medical doctor and graduate of the Thailand Field Epidemiology Training Program

In Thailand Dr Thimasarn saw Plasmodium falciparum grow resistant to chloroquine, sulphadoxine-pyrimethamine, and mefloquine in succession – what a nightmare and challenge! Her knowledge of program implementation is incredible and she understands the realities which governments often face. But more importantly, she never let those hurdles stand in the way of necessary actions or relevant evidence, no matter how difficult the changes would be or how inconvenient the data was. If you work in public health, you understand how valuable this is. Dr Thimasarn’s amazing work ethic has continued at WHO where she can often be found working as late as 8pm in the evening, including Saturdays. It is a type of dedication that is rarely matched.

If you know other malaria heroes and would like to recognize them, please email me a guest post and I will be happy to publish it.


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