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Malaria, the Mostly Forgotten Killer

By Bruce Einhorn In the sweltering heat of the Indian capital, the SARS virus seems very far away. As a Hong Kong-based correspondent for BusinessWeek, I had to find someplace SARS-free to stay for 10 days in order to enter the U.S. for a meeting in early June. So I decided to visit the subcontinent in late May, since no incidents of severe acute respiratory syndrome have yet been detected there.

A good thing, too, since Indians have more than enough to worry about. The weather, for instance. A brutal drought and heat wave have afflicted much of the country, with temperatures in New Delhi regularly topping 104F (40C). Meteorologists are predicting that the monsoon rains -- crucial to replenishing the water supply and providing relief from the oppressive temperatures -- will be late this year. Already, the heat has killed more than 1,000 people.

Last week, a group of medical experts gathered at a five-star hotel in New Delhi to remind Indians that they may have escaped SARS but they have other diseases to fear -- such as malaria. The mosquito-borne illness still rages in India and other tropical countries in the developing world. While the death toll from SARS is less than 800 worldwide, malaria kills about 1 million people in India, Southeast Asia, and Africa every year.

CLASS DIFFERENCE. Sounding the alarm was Dame Bridget Ogilvie, the chair of the Geneva-based Medicines for Malaria Venture (MMV). "The incidence of malaria in Africa is rapidly increasing again. Drug resistance has become severe in Southeast Asia," she said. The disease "has become almost uncontrollable."

The nonprofit organization is leading the effort to develop drugs to control it. Ogilvie was on hand in New Delhi to provide details of a new partnership with India's largest pharmaceutical company, Ranbaxy Laboratories. It will be working with MMV to develop antimalarial drugs.

Ogilvie isn't shy about voicing a little resentment at the amount of attention that SARS has gotten. While "it makes good sense to stamp [the SARS virus] out," she added that the reaction to SARS has been "disproportionate," tracing the reaction to issues of class and nationality.

PUSH AND PULL. Few people in the developed world have to fear getting bitten by a malaria-carrying mosquito. In contrast, ordinary people in the U.S. or Western Europe can easily identify with SARS victims, many of whom are residents of some of the world's most affluent cities: Hong Kong, Singapore, and Toronto. "I understand that people are afraid of SARS," she said. "Because it affects you and me."

While malaria researchers work for years, sometimes decades, in obscurity, SARS experts have quickly found themselves in the world spotlight. "The people who have malaria have no money," noted Ogilvie. "There's no 'market pull,' to use the phrase that that pharmaceutical industry uses." Worldwide research on malaria last year amounted to just $100 million, a tiny amount compared to the vast sums spent on higher-profile illnesses like AIDS and now SARS. Few big pharmaceutical companies pay any attention at all to malaria research.

Since malaria has no pull for researchers, MMV is trying to exert some push. It started three and a half years ago with funding from the Bill & Melinda Gates Foundation and from some Western governments. The group has 15 research projects in the works now, with several others planned. The partnership with Ranbaxy is the first that MMV has established with a company located in a region seriously affected by malaria. "I'm thrilled this [partnership] is in India, where the disease is endemic," said Ogilvie.

PLAGUE TIME? For Ranbaxy, working with MMV provides a chance to improve its image as a good corporate citizen, and maybe earn some money down the road if a better treatment or even preventive remedy can be developed. "We want to develop a lifesaving drug that an average person in Africa, Southeast Asia, and India can afford," said Rashmi Barbhaiya, head of research and development for Ranbaxy. The MMV deal is the first of its kind for Ranbaxy, but Barbhaiya promises that it'll be doing more "in the near future."

One good thing that may come from the SARS outbreak is a new interest in combating deadly diseases of all sorts, from SARS and AIDS to malaria and tuberculosis (another disease affecting mostly poor people that's on the upswing).

"Since 1976, over 30 new infections have appeared," Ogilvie said ominously. "We have a revolution going on in infections that [could] kill us all." Whether it's a new coronavirus in China or a drug-resistant strain of malaria in India, experts like Ogilvie have no shortage of enemies in the war against disease. Einhorn covers technology from Hong Kong for BusinessWeek. Follow his weekly Online Asia column, only on BusinessWeek Online

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