25 October 2012

New Harvard Scholar in Residence Hones in on Malaria Innovation Strategies

The Harvard Malaria Imitative launched a new ExxonMobil Malaria Scholar in Residence Program that brings Dr. Regina Rabinovich, former Gates Foundation Director of Global Health Infectious Diseases, to Harvard in order to pursue innovative strategies to combat malaria.

ExxonMobil continues its established collaboration with Harvard by supporting the position. The oil giant has invested over $100 million in bednets, anti-malarial medicines and sector leadership since 2000. Part of that funding has gone to the June Science of Eradication event that brought together individuals from various sectors to train them as future leaders in the malaria fight.

“ExxonMobil has long valued our partnership with Harvard to combat malaria,” said Suzanne McCarron, president of the ExxonMobil Foundation. “Dr. Rabinovich is bringing her unique expertise and knowledge to this program, and we look forward to seeing the impact this partnership will have on the malaria field.”

Regina Rabinovich, MD
The WHO estimates that there were 216 million cases in 2011. Mortality rates caused by malaria are down by over 25% since 2000, but malaria was still responsible for killing roughly 655,000 people in 2010. There are know interventions to prevent the spread and reduce the impact of malaria, but the disease continues to affect children in sub-Saharan Africa at a high rate.

Dr Dyann Wirth launched the Harvard Malaria Initiative in 1997, a point in time when research into malaria was nascent and interventions that are commonplace today, such as long lasting insecticide treated bednets, were in the early stages of testing. 

“Over the course of my career, I’ve had the privilege to work closely with researchers, non-profits,
governments and foundations,” Dr. Rabinovich said. “Now, I’m excited to join one of the world’s leading academic institutions and to help leverage Harvard’s resources in the fight against malaria.”

The Harvard Global Health Institute brings together a range of schools at Harvard, accelerating Dr. Rabinovich's desire to work across the university. She stressed the ability to access the technical knowledge of various university schools which can apply directly to coordinating the malaria response effort. "We are unlikely to have a silver bullet for malaria," argued Dr. Rabinovich.

Technical responses like artemisinin combination therapy (ACT) have proven to be an effective solution to treating malaria. ACT provided a promising alternative in parts of the world where traditional treatments were experiencing resistance. 

However, ACT resistance was observed in Vietnam earlier this year. The WHO expressed concerns about the resistance and the ability to control it from spreading throughout the region. “Currently Vietnam does not have enough money available to do what has to be done to address the artemisinin-resistance issue,” said WHO’s Christophel to IRIN in September. “You need to have special programmes. A bednet is only given to people who register [with authorities]. If you are not registered then how are you going to get your bednet,” she said, referring to workers in the informal sector.

Part of the challenge to ACTs is the compliance. "Current ACTs are hard to take given the combinations, strange timings and varying information," explained Dr Rabinovich. Since the problem of resistance to ACTs are localized, Dr Rabinovich says she is concerned more with the potential resistance to insecticide treated bednets. The insecticides used for bednets have been employed for years and an alternative is not ready.

While the problems and challenges may seem technical, governance is the issue that sits atop Dr. Rabinovich's agenda for the year. She indicated that convening bodies like the Roll Back Malaria Partnership could benefit from better coordination and a reassessment as to how to address malaria.

The regionalization of the response to malaria is one area that interests Dr. Rabinovich. Presently, individual national governments determine how to prevent and respond to malaria. Differing responses between countries can lead to problems for one another. Malaria, like all infectious diseases, does not respect borders.

As a disease, malaria provides an avenue to gain involvement in all aspects of health from systems to frontline health workers and researchers to logistics. "Malaria represents all aspects of global health," said Dr. Rabinovich.

The overarching goal of the Scholar in Residence is to focus on applied malaria control, treatment and prevention strategies, says the official announcement. That will include areas such as disease eradication efforts; drug and vaccine strategies; financial tools and strategies; and modeling to evaluate the effectiveness of eradication strategies.