Malaria is long thought of as an African problem. Yet close to home, in the Asia-Pacific region, over 2 billion Asian lives are at risk of endemic malaria.
Tens of millions to possibly hundred of millions get infected, and tens to hundreds of thousands die from the disease each year. These staggering figures go unreported because many of the victims are invisible, belonging to the most isolated, poor and voiceless in the Asia-Pacific.
The Asia Malaria Images Exhibition, which aims to push awareness on malaria, opened at the 8th level of the National Library on September 9. The exhibition is open to the public, and is a joint effort by photographer Pearl Gan, Professor J. Kevin Baird, the Wellcome Trust, the Eijkman Institute, the University of Oxford and the Oxford University Clinical Research Unit (OUCRU).
The photo gallery puts a face to the many suffering and overlooked in the Asia-Pacific, where rerouted public perception has caused funds and resources to falter in this region.
As described in the gallery, “The project and exhibition takes aim at that injustice, allowing you to see those people, their humanity and suffering, and to learn about malaria in the Asia-Pacific.”
Together with the event, an Asia Malaria Images Exhibition Opening Talk was conducted at The Pod in the National Library Board.
Speakers included Prof Baird himself, as well as invited guests and partners including Associate Professor John CW Lim, executive director of the Centre of Regulatory Excellence at Duke-NUS Graduate Medical School.
In his opening speech, Dr Lim brought the audience up to date with a report on the malaria situation. He stressed the importance of renewed efforts to establish efficient regulatory systems. “…[P]rogress toward malaria elimination in this region must be accelerated through greater investments, and the development of active control and intervention, robust disease surveillance systems, improved diagnostics, more effective medicines, and increased support for innovation and research,” he emphasised.
Dr Lim proposed that enhancing integration of national malaria control programs with national health systems, and ensuring the research and surveillance efforts were not being duplicated, were two aspects that could well benefit from further review and streamline. “There also needs to be constant dialogue placed on well-researched evidence, to ensure that adequate resources continue to be made available and they’re targeted to bring maximum impact,” he added.
Prof Baird, head of the Eijkman Oxford Clinical Research Unit in Jakarta, followed the opening with an introduction to the project’s mission, as well as an overview into the global map of malaria.
He shared his own personal experience as a malaria victim, and also highlighted how seven species of plasmodial parasites known to naturally infect humans occur here, with the Plasmodium falciparum and Plasmodium vivax as the overwhelmingly dominant species.
He describes the visible malaria problem as the “ears of the hippopotamus” and that the invisible portion stays invisible because of the nature of malaria with its sub-patent, latent, and asymptomatic stages. Another issue is the isolated and migrant nature of victims in the Asia-Pacific, which makes numbers hard to confirm.
“Just because we don’t see evidence of danger, doesn’t mean there’s no danger,” Prof Baird warned.
Professor Laurent Renia, executive director of the Singapore Immunology Network (SIgN) spoke next on “Malaria in Singapore before and after elimination”. He went through documented cases of malaria in Singapore, and how eradication efforts have seemed successful but are not foolproof.
He presented a case of an army personal being misdiagnosed after field training in Sarawak in 2006, as well as the 17 cases of infection at Jurong Island in 2009, as examples of how quickly malaria can return as an epidemic.
The last two speeches were made by Professor Peter Rainer Preiser, chair of the School of Biological Sciences and professor in molecular genetics and cell biology at Nanyang Technological University (NTU), and Kevin SW Tan, associate professor at the Department of Microbiology, National University of Singapore.
Prof Preiser covered a little on using genomics as a tool to aid malaria research, while Prof Tan shared his own research developments on destroying the parasite. Prof Tan indicated that cell death of the parasite can be triggered by targeting the lysosome or ”stomach” with specific drugs, potentially opening up a novel approach to malaria treatment.
The talk closed with a Q&A session. When asked on how Singapore can participate and help its neighbours in this war against malaria, Prof Baird suggested: “Regional leaders in politics, economics, and technology demonstrate leadership by stepping up to help solve regional problems, including malaria. The Asia Pacific Leaders Malaria Alliance, based in Singapore, is an example of that. APLMA is an expression of regional governments wishing to solve the malaria problem.
“The point here is simple: Singapore can and should use its advanced biotechnological capacities to effectively outfit Asia Pacific for attacking the malarias that occur here. Most malaria scientists in North America, Europe, and elsewhere are not doing this for us — they are focused on the African malaria problem. That’s why our toolbox here in Asia-Pacific is full of tools effective in Africa but not here. So I would say to Singaporean scientists, ‘Give us a toolbox that works for our unique problem.’ “
The audience adjourned to the photo exhibition where vivid depictions of malaria victims were accompanied by detailed descriptions of each situation. The unadulterated suffering captured on each face reinforced the messages conveyed in the afternoon talk, and drove home the urgency of eliminating the disease.
All images: Ashley Mak Photography