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Comment by SemanticFog | Hacker News Reader

Most vaccines are against viruses and bacteria. Malaria is a more complicated organism, a protist with many local varieties, and a tremendous ability to evolve around vaccines and medications in general.

Natural immunity to malaria is often limited to the local variant -- go a couple hundred miles, and you have no resistance at all. Vaccines rely on the body's natural immune system, so it is nearly impossible to create a single vaccine that is effective across the world.

For this reason, I'm highly skeptical that this initial test result will hold up with broader trials. BTW my spouse is a malariologist, formerly at WHO, and I've been a witness to much of the fight against malaria over the years.

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what is you spouse's take on artemisinin based medications?

http://www.who.int/malaria/publications/atoz/meeting_briefin...

From what i read elsewhere it works almost like a magic without producing resistance, and i'm wondering what would be the first hand account of a practitioner.

Nothing fails to produce resistance. It's all a balancing act.

IANAE(pidemiologist), but it's my understanding that if you fast and hard enough, the critter doesn't have time to adapt. See smallpox.

Smallpox was eliminated through a vaccine campaign. Resistance against vaccines is generally different from resistance from treatments. For example, since vaccines are in place pre-infection, the amount of target microbes in the body at time of action is pretty low, giving a much higher chance of killing them all. Treatment is usually given after infection, where there will be a large amount of target microbes. This will substantially increase the probability some critter surviving with more resistance genes and then passing them on.

There's already artemisinin resistance starting in several places around the world, especially the Thai-Cambodia border, a very chaotic area with high endemic malaria.

The main problem is that cheap medications are often out of date or have improper dosage. Also, people stop taking medication when they feel better, but before the parasite is eliminated. The result is resistant parasites survive the treatment, and then spread.

We have maybe a decade of artemisin usability in the hottest areas. Could be more or less depending on how efficient public health practices are. But no way is it a permanent cure.

The artemisinin resistance is very scary. Cambodia is where Chloroquine resistance developed, which has since spread to Africa. If artemisinin resistance were to become widespread too, it would be a disaster. Containing it is a very tough problem, but there are efforts underway to try. One of the members of my lab is traveling to the area soon to test a new screening method.

http://www.who.int/malaria/diagnosis_treatment/arcp/en/index... http://mango.ctegd.uga.edu/jkissingLab/

thanks, i see. With developing resistance and being cheap, i wonder whether the artemisinin would fall off the radar of the industry - i mean it has shown good cancer cell killing efficiency and selectivity in tissue samples and mice, yet i haven't heard about serious research beyond that.

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