All it takes is a team. One goal keeper, two strikers and a reliable mid-field

‘What about a primer in Malaria for Nature?’ asked Meg in an e-mail. Who can say no to Nature?
All it takes is a team.  One goal keeper, two strikers and a reliable mid-field

The Primer in Nature Reviews Disease Primers is here:

The accompanying PrimeView is here:

As a graduate student I can vaguely remember the excitement of actually publishing papers in Nature. A generation later, it still carries that cachet. Not just the wide readership, but also something of the process and the rigour – working with editors who correct our Swiss or American English back to the house style.  Who force us to say exactly what we mean, and if its really not clear rewrite things.  And then there are the graphics, where the in-house artists have a way of presenting data in a way that we hadn’t thought of.

But I get ahead of myself.  Professor Margaret Phillips, otherwise known to us all as Meg is a structural biochemist who works in Texas, and has been part of a project with colleagues in Seattle and Australia which has put an inhibitor of the enzyme dihydroxyorotate dehydrogenase (rolls off the tongue, doesn’t it?) into the clinic for malaria.  She was asking Jeremy Burrows and myself, both of whom work for a Swiss charity that catalyses the discovery development and delivery of new medicines against malaria, known as MMV or Medicines for Malaria Venture.    Putting together a team who could write about malaria all the way from the lab to the clinic and the market place, needs careful thought, there is a lot of ground to cover.  Nature Reviews Disease Primers increased our challenge by saying they wanted to discuss drugs, vaccines and insects in the same 24 pages. 

Like any good soccer team, we needed a good goal-keeper – the person who can make sure we have all the facts.  However, writing about drugs, vaccines and insecticides is somehow closer to being a sleuth than an expert in Medline.  All the data are in the public domain, but you do have to know where to look.  My friend Rob Hooft is just the man for the job, a retired bench scientist, a brilliant writer, but with an eye for detail, he built up a map of all the drugs, vaccines, and insecticides from a mixture of database searches, and instinct for where to find the answers.   He’s kept track of over 100 projects, and regularly updates them, and so is the go-to man if you need to know what people have said about their work.   Any team needs good ‘forwards’ as well: in our field the forwards are the people who actually treat patients. Wes van Voorhis had spent a year with us on sabbatical, and runs a research lab, when not teaching students, examining patients or singing songs about malaria (check out the you-tube to see how real teaching is done these days). Christine Manyando is an Ob/Gyn working in Tanzania, at the hard end of malaria – a disease that is devastating to small infants and pregnant mothers in Africa.  They were able to add the patient perspective, and the overview.  Malaria is a disease that kills 400 000 children per year, and that is a major tragedy.  Too often we forget that the large impact on society, and it’s the reality of clinical practice that brings drug discovery and development back to life.

Why is this all important?    Bringing down the death toll in malaria needs a constant supply of new people working on the problem.  We need to be continually bringing in people with new skills from industry and academia who have not worked on the disease before and who can bring new insights.  Our drug screening is built on ideas from neurobiology 15 years ago, our translational medicine is built on insights from rheumatology.  Its not necessary to continually reinvent the wheel, simply to bring people with new insights into the discussion.  Is the paper worthwhile?  Well the pictures are nice, (thanks to the graphic artists) and the text reads well (thanks to the editors).  If only one or two people read it, and are able to bring a new insight from combining their background with a view on the problems of malaria, then it will have been well worth it.

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