Some lessons for malaria from the Global Polio Eradication Initiative.

The Global Polio Eradication Initiative (GPEI) was launched in 1988 with the aim of completely clearing wild polio viruses by 2000. More than three decades later, the goal has not been achieved, although spectacular advances have been made, with wild polio virus reported in only 2 countries in 2019. In spite of such progress, novel challenges have been added to the equation, most importantly outbreaks of vaccine-derived polio cases resulting from reversion to neurovirulence of attenuated vaccine virus, and insufficient coverage of vaccination. In the context of the latest discussions on malaria eradication, the GPEI experience provides more than a few lessons to the malaria field when considering a coordinated eradication campaign. The WHO Strategic Advisory Committee on Malaria Eradication (SAGme) stated in 2020 that in the context of more than 200 million malaria cases reported, eradication was far from reach in the near future and, therefore, efforts should remain focused on getting back on track to achieve the objectives set by the Global Technical Strategy against Malaria (2016-2030). Acknowledging the deep differences between both diseases and the stages they are in their path towards eradication, this paper draws from the history of GPEI and highlights relevant insights into what it takes to eradicate a pathogen in fields as varied as priority setting, global governance, strategy, community engagement, surveillance systems, and research. Above all, it shows the critical need for openness to change and adaptation as the biological, social and political contexts vary throughout the time an eradication campaign is ongoing.

A Roadmap for the Development of Ivermectin as a Complementary Malaria Vector Control Tool.

In the context of stalling progress against malaria, resistance of mosquitoes to insecticides, and residual transmission, mass drug administration (MDA) of ivermectin, an endectocide used for neglected tropical diseases (NTDs), has emerged as a promising complementary vector control method. Ivermectin reduces the life span of Anopheles mosquitoes that feed on treated humans and/or livestock, potentially decreasing malaria parasite transmission when administered at the community level. Following the publication by WHO of the preferred product characteristics for endectocides as vector control tools, this roadmap provides a comprehensive view of processes needed to make ivermectin available as a vector control tool by 2024 with a completely novel mechanism of action. The roadmap covers various aspects, which include 1) the definition of optimal dosage/regimens for ivermectin MDA in both humans and livestock, 2) the risk of resistance to the drug and environmental impact, 3) ethical issues, 4) political and community engagement, 5) translation of evidence into policy, and 6) operational aspects of large-scale deployment of the drug, all in the context of a drug given as a prevention tool acting at the community level. The roadmap reflects the insights of a multidisciplinary group of global health experts who worked together to elucidate the path to inclusion of ivermectin in the toolbox against malaria, to address residual transmission, counteract insecticide resistance, and contribute to the end of this deadly disease.

Getting ready for malaria elimination: a check list of critical issues to consider.

In recent years, a renewed interest in malaria elimination and eradication has emerged and seems to be rooting in the minds of the scientific community, public health specialists, funding bodies, policy makers and politicians. Malaria eradication will certainly benefit from improved and innovative tools; notwithstanding novel knowledge in fields ranging from basic science to mathematical modelling and health systems research. However, the elimination of malaria also encompasses a broad range of essential aspects that countries and other actors need to consider when thinking of embarking on such an adventure, including the implementation of innovative strategies, the ability to incorporate the most up-to-date evidence into policy, the integration of malaria into the broader health agenda, the strengthening of surveillance and health systems, capacity building, funding, advocacy and, very importantly, research. While in some cases this enthusiasm is clearly justified, some countries are still a long way from realistically advancing towards elimination. This paper attempts to provide guidance on all the necessary issues that should be considered when initiating a malaria elimination program.

Shaping biomedical objects across history and philosophy:a conversation with Hans-Jörg Rheinberger.

Historical epistemology, according to the historian of science Hans-Jörg Rheinberger, is a space through which "to take experimental laboratory work into the realm of philosophy". This key concept, together with the crucial events and challenges of his career, were discussed in a public conversation which took place on the occasion of Rheinberger's retirement. By making sense of natural phenomena in the laboratory, the act of experimenting shapes the object; it is this shaping which became the core of Rheinberger's own research across biology and philosophy into history. For his intellectual agenda, a history of the life sciences so constructed became "epistemologically demanding".

Shaping biomedical objects across history and philosophy: A conversation with Hans-Jörg Rheinberger

Historical epistemology, according to the historian of science Hans-Jörg Rheinberger, is a space through which «to take experimental laboratory work into the realm of philosophy». This key concept, together with the crucial events and challenges of his career, were discussed in a public conversation which took place on the occasion of Rheinberger’s retirement. By making sense of natural phenomena in the laboratory, the act of experimenting shapes the object; it is this shaping which became the core of Rheinberger’s own research across biology and philosophy into history. For his intellectual agenda, a history of the life sciences so constructed became «epistemologically demanding» (AU)

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Some lessons for the future from the Global Malaria Eradication Programme (1955-1969).

Encouraged by the early success of using dichloro-diphenyl-trichloroethane (DDT) against malaria, the World Health Organization (WHO) embarked on the Global Malaria Eradication Program (GMEP) in 1955. Fourteen years later, the campaign was discontinued when it was recognised that eradication was not achievable with the available means in many areas, although the long-term goal remained unchanged. During the GMEP, malaria was permanently eliminated from many regions. In other areas, however, substantial gains were lost in resurgences, sometimes of epidemic proportions. During the 1970s and 1980s, because of economic and financial crises, international support for malaria control declined rapidly, but in the past decade, following increasing demands from endemic countries and promising results from scaling up of control activities, interest in malaria elimination and the long-term goal of eradication has received international political and financial support. In 2007, there was a renewed call for malaria eradication and a consultative process to define a research and development agenda for malaria eradication (malERA) was established. Lessons learned from the GMEP (1955-1969) highlight the fact that no single strategy can be applicable everywhere and that a long-term commitment with a flexible strategy that includes community involvement, integration with health systems, and the development of agile surveillance systems is needed.

[From the sociological factor to the genetic factor. Genes and disease in the pages of El País (1976-2002)]. / Del factor sociológico al factor genético. Genes y enfermedad en las páginas de El País (1976-2002).

Transformations in the Spanish public discourse on the link between genes and disease are analysed by an attentive reading of the journalistic texts published in El País between 1976 and 2002, and the newspaper's model of popularisation is explored. Whereas in the seventies a social and complex vision of disease was favoured, by the nineties the genetic approach was predominant. El País supported this "geneticisation" and forested an increasingly neutral and apolitical image of science.