A Watertown native is making inroads in battling one of the oldest and deadliest diseases known to mankind.
More than 1.2 million people died from malaria worldwide in 2010, according to the Institute for Health Metrics and Evaluation at the University of Washington. Forty eight percent of deaths were children 5 and under. Most of the deaths were in Africa.
Weve probably spent the most amount of time and money researching it, and yet it still persists, said Stephen M. Rich, a 1984 graduate of Immaculate Heart Central High School and a 1989 graduate of St. Lawrence University, Canton. The reason is because it changes. It evolves. It has the ability to adapt to virtually everything we do.
But Mr. Rich, a molecular parasitologist and a zoonotic disease expert at the University of Massachusetts Amherst, and director of the colleges laboratory of medical zoology, is leading a research team that has developed a new low-cost approach to fighting malaria, which is spread by infected mosquitoes.
The mission is to fight the mosquito-borne parasite Plasmodium falciparum, which causes the deadliest form of malaria. It has developed resistance to every drug tried against it.
There is no effective vaccine against malaria. The drugs taken to try to prevent it are the same drugs used to treat the disease, according to the Mayo Clinic. No antimalarial drug is 100 percent effective.
Those drugs, Mr. Rich said, although affordable to someone in the U.S., may have a cost equal to the annual salary of someone in Africa.
A whole plant therapy approach Mr. Richs team is working on may be a much cheaper and effective alternative.
Mr. Rich, son of Stephen L. and Catherine M. Caye Rich, Watertown, took some time to discuss the approach during a phone interview from his office in Amherst.
People have known about the effectiveness of the artemisia annua plant, also known as sweet wormwood, in treating malaria for thousands of years, Mr. Rich said.
The Chinese used it as a medicine to treat fevers, before they called it malaria, Mr. Rich said. They would take the plant, make a tea and it cured them of some of the fevers they suffered from, many of which probably were malaria, in retrospect.
During the Vietnam War era, Mr. Rich said, Chinese leader Mao Zedong charged his scientists with finding a cure for malaria, which was ravaging North Vietnamese troops.
They scoured all these past records and they found the plant that had been used for thousands of years, Mr. Rich said.
They then isolated the pure drug extract, artemisinin, that fought malaria.
It turns out it worked pretty well Mr. Rich said.
But there were two issues with it.
Its not cheap enough that you can get it to enough people so that its going to have an impact we wanted to have, Mr. Rich said.
Its also in short supply.
We have to extract it from the plant, Mr. Rich said. The plant doesnt produce very much of that chemical and it creates a real shortage.
A chemical copy, he said, would be even more expensive.
The whole idea was how do we get more of this white powder out of this plant? Mr. Rich said.
He noted that Pamela J. Weathers at Worcester Polytechnic Institute in Massachusetts had spent years studying the artemisia plant with research physician Dr. Doug Golenbock at the University of Massachusetts Medical School. It was found that when mice were given the whole artemisia they had more of the plant-based compounds in their blood than if they were given an extract.
But Ms. Weathers didnt know how to test her method in regard to malaria, Mr. Rich said.
I said, Youve come to the right place, he said.
His team found that mice treated with low-dose, whole-plant artemisia showed significantly lower parasite loads than those treated with much higher doses of the purified artemisinin drug or a placebo.
The long-term plan is to grow artemisia in large quantities in Africa and other regions hit hard by malaria.
Were studying this all in mice, Mr. Rich said. It has to be demonstrated it works equally well in people.
The plant, Mr. Rich said, can be dried and pressed into tablets or put in capsules. It has also been discussed using it as a powder to mix with milk. Smoking it, he said, is ineffective.
Mr. Rich said his sources in Africa have indicated they are eager to try the process, a fast-track approach at odds with the Food and Drug Administrations more cautious approval process.
In Africa, they dont really care, Mr. Rich said. Theyre dying, so theyll use whatever is available. Our African colleagues on the ground are treating malaria and see patients die from it in the hospital every day. When they read our paper, they said, We dont need any more proof. Were just going to go ahead and do it.
But Mr. Rich said that approach is not something his team condones.
If this, or any malaria treatment, is not used properly, it can actually make matters worse because its misuse can help the parasite overcome the drug by evolving resistance, he said.
Mr. Rich noted that this has happened several times in the last century, most notably in the 1950s and 1960s when more than 60 countries worked together to try to eradicate malaria.
We want to avoid that, Mr. Rich said. We are pushing hard to get more funding in our lab to do these important preliminary investigations.
In the most recent experiments, it was found that rodent bloodstreams had eight times the minimum concentration of the compound required to kill the Plasmodium parasite when the whole plant was used.
With this new treatment, Mr. Rich said, parasites may be less able to evolve resistance to the whole plant because the plants makeup is far more complex. It also could drastically reduce the high cost associated with malaria treatment.
Its a local agriculture solution to a global health problem, Mr. Rich said.
He added, It will be a couple of years before were in a position where wed have the proof in line where the World Health Organization would actually get behind it and endorse it.
Mosquitoes that spread malaria, Mr. Rich said, are particularly vexing because they have certain characteristics: They come out only at night, biting people as they sleep, and they prefer the blood of humans.
Most mosquitoes would rather feed on a bird, or whatever else is out in the wild, Mr. Rich said. We sort of end up in the middle between them and what theyre preferring. But these malaria mosquitoes, we are their favorite food. Theyre looking for us.
They also seek out human habitations.
They evolved with us, Mr. Rich said.
The Institute for Health Metrics, in its report released last year, noted that starting in 1985, malaria deaths grew every year before peaking in 2004 at 1.8 million worldwide. Since then, the number of deaths fell annually, and between 2007 and 2010, the decline in deaths was more than 7 percent each year. The decline was attributed to better use of insecticide-treated bed nets and artemisinin-combination treatments.
After receiving his degree in biology from SLU, Mr. Rich attended the University of Vermont in Burlington, where he received his masters degree in 1993. He received his Ph.D from the University of California in 1997.
Besides malaria, Mr. Rich h also as focused on the study of Lyme disease, a tick-borne bacterial infection that can cause skin, nerve, heart and arthritis complications. His Amherst lab offers testing for a variety of tick-borne pathogens. In general, his work at the lab focuses on the evolutionary dynamics of pathogen and host populations and intervening in the transmission of those pathogens.
In 1992, on a tiny island in Maine, Mr. Rich discovered Lyme disease-infected Norway rats. Until that find, it was believed that only mice carried the disease.
His research into Lyme disease has been funded by the Centers for Disease Control and Prevention, the American Museum of Natural History and the National Science Foundation.
Mr. Rich said he first fell in love with biological research at SLU.
Thats what I wanted to do with my life, but didnt know what that would entail, he said.