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Mosquitoes in Mali
Like Plowe, Djimdé divides his time between the lab and the field, where he is focusing his research on the genetics of drug resistance.
“We’ve been looking at a more holistic approach to understanding drug resistance,” says Djimdé, which would take into account “the many factors related to the response to antimalarial drugs.” Those factors include the genetics of the human hosts—including acquired immunity and how people metabolize malaria drugs—and of the malaria parasites and the mosquitoes that spread them. “We are trying to understand the interplay among the parasite, the mosquito, and the drug,” he says. “How drug resistance is established in a community, and how it spreads across time and geography.”
Collaborating with entomologists, Djimdé’s group catches mosquitoes in the villages being studied, harvests their eggs, and develops new generations of the insects that are kept in the laboratory and used for experiments.
They also work closely with villagers. “It can take several months of preparatory work before a community agrees” to take part in a research project, he says, requiring approval by an ethics panel and village elders as well as cooperation with traditional healers. “You have to respect the customs and the organization of the community. You have to find a way to explain what you plan to do, what risks are involved, and the likely benefits for the community and perhaps for mankind in general.”
In one project, Djimdé’s group, in collaboration with Wellems’ NIAID lab, is examining the parasite’s resistance to quinine, the time-tested drug derived from tree bark that is often used to treat the most severe cases of malaria. (Quinine is a natural product that differs markedly from chloroquine, which was synthesized by German scientists and refined as an antimalarial drug by U.S. researchers during World War II.) He is also trying to determine the safety of, and whether resistance is emerging to, the newest generation of ACTs.
The fight against malaria has continued for centuries—and intensified in recent years with the advent of the World Health Organization Global Malaria Programme and related efforts sponsored by major aid organizations. In recent years, optimistic funding agencies, such as the Bill & Melinda Gates Foundation, have suggested that malaria can be eliminated, and more than two dozen countries have launched efforts that they hope will stamp out the disease, with some progress reported.
Plowe and Djimdé support the ambitious goal. “The malaria research world has been transformed by the call for eradication,” Plowe says. But the two say it will take years of research to stop malaria in nations where the disease is now endemic and widespread.
“I think eradication is possible, but not in the near future,” says Djimdé. “The tools we have today—notably, the artemisinin-based combination therapies and mosquito nets, with the possibility of an efficacious vaccine against malaria—can be very effective if they are available and are deployed. In specific communities, they can lessen malaria to the extent that it is no longer a serious public health problem.
“I don’t think we have the tools to [eradicate malaria] yet. This will require sustained funding and decades of research,” he adds.
Both Djimdé and Plowe will continue to lead the way. “Djimdé is now one of the best-known researchers in all of Africa,” says Plowe. Although they’re using different approaches to tackle malaria, the two scientists remain friends after nearly 20 years—sometimes mentoring the same students and discussing their separate projects. Even their families are close. “It’s been a great friendship.” 
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