Malaria

‘Malaria is thought to afflict over 500 million people worldwide and cause nearly three million deaths each year, more than 90% of which occur in sub-Saharan Africa. By cracking the genomes of the malaria parasite, Plasmodium falciparum, and the primary mosquito that spreads it, Anopheles gambiae, scientists hope to be able to develop new drugs, vaccines, insecticides and insect repellents. Many researchers believe the genomes represent an important landmark in science. However, not all are convinced.’ BBC News, 2002

“This is an extraordinary moment in the history of science. At last, the enormous power of modern technology is penetrating the mysteries of an ancient disease, a disease that continues to kill millions. Now the most advanced tools of science are at last being trained on one of the biggest killers in the developing world”. Dr Carlos Morel, Director, World Health Organisation Tropical Diseases Research Programme, 2002

“We are hopeful that this wealth of information will translate into new drugs, vaccines and insecticides that will more effectively control malaria and, ultimately, lift a burden of suffering from millions.” Dr Michael Gottlieb, Parasite Expert, US National Institute of Allergy and Infectious Diseases, 2002

“If we can identify the receptors that mosquitoes use to smell humans, we should be able to design novel repellents and attractants that can substantially reduce the incidence of malaria, West Nile encephalitis, dengue and yellow fevers and other mosquito-borne diseases.” Dr Laurence Zwiebel, Vanderbilt University, Tennessee, US, 2002

“This great discovery will make a massive difference to those of us working on a cure for malaria. It’s like giving directions and a route map to someone who is hopelessly lost in the middle of a city. Now we can see we are and where we can go. In my area of research it’ll give us an insight into the gene that can be used to interfere with parasite development in the mosquito or the gene that’s involved in sex determination of an insect.” Professor Andrea Crisanti, Imperial College London, UK, 2002

“I’m sceptical that the Anopheles mosquito genome will actually be useful in attempts to control malaria in very poor countries and I have a feeling that projects on the genome are done because molecular biologists think they can be done and are exciting to do. The justifications are then added on afterwards. One suggestion is that one could make tailor-made insecticides. However I doubt if these would be affordable by governments with health budgets of $5 per head per year for all diseases”. Professor Chris Curtis, London School of Hygiene and Tropical Medicine, UK, 2002

‘It is also important to explore applications of genomics in the  HYPERLINK "http://www3.who.int/whosis/genomics/genomics_report.cfm)" improvement of health in the developing world, where both human and non-human genomics will play significant roles. If we take malaria as an example, a better understanding of human genetic factors that influence susceptibility and response to the disease, and to the drugs used to treat it, could have a significant global impact. So too could a better understanding of the malarial parasite itself and of its mosquito vector, which the recently reported genome sequences should provide. It will be necessary to determine the appropriate roles of governmental and non-governmental organizations, academic institutions, industry and individuals to ensure that genomics produces clinical benefits for resource-poor nations, and is used to produce robust local research expertise.To ensure that genomics research benefits all, it will be critical to examine how genomics-based health care is accessed and used. What are the barriers to equitable access, and how can they be removed? This is relevant not only in resource-poor nations, but also in wealthier countries where segments of society, such as indigenous populations, the uninsured, or rural and inner city communities, have traditionally not received adequate health care.’ A Vision for the Future of Genomics Research, US National Human Genome Research Institute, 2003

Anopheles gambiae - Mosquito Genome

Reaper mosquito; how can it be? Just brushed

by a marshland hand - crushed into frail black

scribble-lines no more substantial than a word;

scrambled, all unwritten among the tiny stolen

poppies of my blood - splattered red on white.

Reaper mosquito; sucking scythe - alighting,

dark Bonsai angel - filthy fallen insect, anti-

butterfly, on three million treasuries of love,

without heart; his perverted high bell tolling.

Why do you keep coming out of the swamp?

Reaper mosquito, sounding like a Greek hero,

Anopheles - Anopheles the Brave - the Great;

but dark insect prince - anaesthetising single

sword, playing your excruciating fairy violin,

drinking song; no saving grace like tiger pelt,

stinging bee who brings flowers to life,

fills combs with golden honey. Why do

you hate us so - desiring souls fluttering

up like flotillas of magnolia - surprised

green souls, old blues, baby souls white

as swans; shivering of 500 million, sweat

and tears. Is it more drink, tipple for you?

Bitter as aloes, your sugar, own dark milk

for Plasmodium falciparum - fat parasites,

vibrant in nurseries of your life, disgusting

vampire lifestyle - culturing Malaria, Dengue

Fever, Yellow Fever, West Nile Encephalitis -

death’s new music. Exploitive inventive nature,

plotting in your swamp, never evolving to lamb,

lion, eagle, compassionate artist exploring, nor

enlightened, kind, purposeful; even if stars kneeled

down with age, creaked among the heavens, or time

relaxed and took it easy. You are too far gone - like

Hitler, ineligible for Nature’s redemption; principles

reprogrammed for growing you tiny butterfly wings -

a new love of flowers and sugar - leaving animals be.

Always you’ll sail in warm foetid currents - dangling

fragile legs like a clutch of brittle grassbones, smiling

idle wickedness, singing. But ignorant of our counter-

attack - enhanced eyes, advancements - now we have

your plans you see, your blueprint; we know everything

about you - like a Meccano model with a trillion pieces,

Lego house dismantled to the plastic molecules; and we

are coming – shining, as we see nothing of light in you

to save; even your eradication we might see as blessing.

“Determining the genome sequence of both the malarial parasite and the mosquito vector are massive achievements that bring the hope of eradication closer. The biggest challenge for the future will be in translating this high technology research into low technology control strategies that are appropriate for the developing world”. Professor Johnjoe McFadden, School of Biomedical and Life Sciences, University of Surrey, UK

‘The solving of the malaria problem has been called the most dramatic episode in the history of medicine. Malaria for centuries had been the most common infective disease throughout the tropics, but its cause was unknown…it was thought to be due to poisonous emanations from marshes… in 1880, a French army doctor, Alphonse Laveran, observing a drop of blood from a malaria patient under a microscope, saw minute parasites living on the red corpuscles. How these entered the blood stream remained a mystery until the Englishman Ronald Ross proved they were transmited by mosquitoes…. Ross wanted to be a writer, but was persuaded by his father to take up medicince… in his spare time he studied literature and writing poems.’ Faber Book of Science, 2005

Who would have suspected the mosquito

Who would have suspected you - frail, windblown

rickle of brown lines, your singing as high as stars,

love for blood so delicately drawn - understanding

anti-clotting red chemistry; inhabiting the marshes

nobody wants, their spooky luminosities, cauldron

of germs troubling humans, but not you - orbiting

above water in speckling choirs, dancing daintily –

who would have thought iron built these hair-limbs,

old-sellotape wings – perhaps your lack of shimmer

in the lights of evening which illuminate most other

creatures, make sparkling, silver and gold, other flies -

fungi to glow; how you just loom, spindly dark thread,

with your teasing warning song, written in a strange

piercing signature off the scale of birds and humans,

was a clue to your nature; its lack of light, full of

the dark poetry of sickness, suffering and death -

though your infection of earth is drawn to light,

battering your emaciated fragility at the bulb –

unafraid, determined; after all, you have brought

down warm millions - generations of mankind -

fought medicines and superstitions; survived always.

I’d like to think your making for this light was a sign

of Evolution’s kindly, redeeming hand; hope for you

in the pantheon of animals, insects, flowers and men -

but you have sung your vampiric messages in my ear,

injecting me – must be burst into a scribble on blood.

Evolved Clone Lines on ‘Mosquito Day’ by Ronald Ross, 1897 -

‘This day designing God/ Hath put into my hand/ A wondrous thing. And god/ Be praised. At His command,// I have found they secret deeds/ Oh million-murdering Death.//  I know that this little thing/ A million men will save – Oh death where is thy sting?/ Thy victory oh grave?’ Ronald Ross, In Exile, 1897, Memoirs, 1923, on discovering that malaria parasites are transmitted by  mosquitoes in 1897

‘This day relenting God/ Hath placed within my hand/ A wondrous thing; and God/ Be praised. At His command,// Seeking his secret deeds/ With tears and toiling breath,/,/ I find they cunning seeds,/ O million-murdering Death.// I know this little thing/ A myriad men will save./ O Death, where is thy sting?/ Thy victory, O grave.’ Ronald Ross, In exile, 1897, amended verses of a few days later,  Memoirs, 1923, on discovering that malaria parasites are transmitted by mosquitoes in 1897

‘Ross’s optimism was premature, though it seemed justified for a time…But genes giving resistance to insecticides spread through the mosquito population, and malaria is a major killer diesase once more.’ Faber Book of Science, 2005

Mosquito Allergy

My searching, fishing chisel found the face inside the wood;

in the staggering, drunk shed by the glowing stagnant pond,

where alien green weed, frog music, was luminous, spooky,

brewing God knows what nascent life - peculiar songs spun

in star-pepper soups of late evening under storybook Moons.

Evening after evening in the flushed afterblood of hot summer -

then sliced night under illuminating razor-beam luring helmeted

moths to hot furry deaths crashing pointlessly into ruthless light.

It was like the red Fire-Christ I had seen once - burning in the end

of a beach party bonfire branch; when I smothered, heart on Pause,

but no words or angels came - no end of the world, BIG messages -

until at last, so bored with not understanding, I splashed my albino

eyes in the exhausted sea dragging itself onto dry blue sand like a shipwrecked sailor - then Christ’s face had become a black stump

of remembered flame, features indistinguishable from any carbon.

Each night the mosquitoes’ malevolent high choir needled my ear

with the voices of furthest speckled stars, spotted my prickly skin

with measley wounds. Bursting some during human transfusions,

those delicately drinking lady thieves with impeccable manners -

(do they taste us like vintages?) - I wore small explosions of my

stolen blood, splashing my limbs with tiny blown poppy flowers.

But on I carved, polishing dimpled eye-eggs; puzzling dark hair

from chewy blond fibres, his crown of thorns already made, just

waiting; ferociously green briar that had snared a tree’s grey knee.

Then one morning - my legs, feet, hands agony - elephant-big limbs swollen hard, so distorted, like a Mediaeval plague; even core bones

sore like tree toes swimming concrete, my poor skin squeezed shiny,

too shiny, like balloon-skin ticking – and lunatic itching - anywhere

a triumvirate of incandescent bites bumped; every night my taut skin tortured on the rack of my own bones. Then the itching became a red

insect in itself, merciless, relentless, crawling; never sleeping, resting 

until at last - flowering bruises of deflation, purple/blue/black/yellow.

And I knew the undreaming, trusting immunity of youth had gone -

when danger still can call itself adventure, statistics apply to others,

and all the magnificent hot countries of the world lie feverish, sunny;

waiting like closed books with fabulous titles golden down the spine,

to be opened – where you write your own story in illuminated pages, gorgeous with colours and squinting light; babbling music, muscular smells. Already I wrapped a scarf like a prophylactic neck bandage -

thought of a comforting Scottish doctor, in a busy coughing surgery;

the banshee ambulance’s miraculous materialisation out of nowhere,

being home, with tear germs just pinpricking my ducts with wet light.

And my Christ lay there unfinished in the wood, only just emerging -

with the whining star voices also complaining they were not finished,

would crumple dry and spindly as an anaemic snatch of old cut grass,

wanting their drinks of blood still - mutual injection. On me they had depended, as all-in menu, Table d’hote. I was good food, fuel for their children. I was soft white bread, red wine on tap. They implied I would want blood, for their love was as a vampire’s - their wounds as infected holes for the free giving of blood and gratis receiving of terrible disease.

His lips still sealed inside the dumb wood, not a word could be spoken -