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The Good Fight

Interview by Brian W. Simpson

An adaptable, ancient foe like the malaria parasite will only be conquered with deep knowledge, hard-earned from basic science. That’s the credo of the Johns Hopkins Malaria Research Institute (JHMRI), launched in 2001 with a gift from Michael R. Bloomberg. From its initial conception by Molecular Microbiology and Immunology chair Diane Griffin and then Dean Alfred Sommer, JHMRI has quickly become the largest academic center for malaria research in the U.S., attracting over $10 million in NIH support annually for more than 20 researchers from the Bloomberg School, as well as the Johns Hopkins schools of Medicine and Arts and Sciences. As JHMRI celebrates its first decade, Nobel laureate Peter Agre, who became JHMRI director in 2008, reflects on the Institute and the mission ahead in an interview with Johns Hopkins Public Health editor Brian W. Simpson.

What do most people not understand about malaria?

It’s a very wily organism. It’s a parasite with a cycle of life that is quite complex. It undergoes dramatic changes of costume in going from insects, into the liver, into the blood and then back into the mosquitoes. There are plenty of chances for it to evade our surveillance, and that’s why it’s dangerous.

What are some of the signal achievements in JHMRI’s first 10 years?

Our faculty have made a number of discoveries that are promising. Jason Rasgon has identified agents that will infect these Anophelesmosquitoes and prevent them from reproducing. George Dimopoulos has made really interesting observations on Anophelesimmunology. Marcelo Jacobs-Lorena has engineered Anophelesthat are prevented from actually transmitting the disease. [Former JHMRI professor] Nirbhay Kumar and Rhoel Dinglasan both have interesting observations that may lead to transmission-blocking vaccines. The work of Gary Posner in the Chemistry Department [at the School of Arts and Sciences] suggests that we might be able to counteract the resistance to artemisinins by modifying the drug. Our colleagues at the Malaria Institute at Macha, in rural Zambia, have been able to knock down the prevalence of malaria 98 percent. All of those, I think, are really significant advances.

What are your priorities for the next 10 years?

No. 1, recruiting, attracting and educating the next generation of malaria scientists because this problem will not be over in 10 years. JHMRI was recently awarded a $14 million International Centers of Excellence for Malaria Research grant from NIH.

What does this mean for the Institute?

ICEMR is a new NIH program to launch scientific approaches to field malaria activities in seven regions of the world. We’ve been funded to study malaria in Zimbabwe and Zambia. It really validates the field activities that are ongoing. And it allows us now to interact with malaria centers of excellence elsewhere in the world to see if our experiences can help guide each other.

What’s been missing from the global fight against malaria?

Two things stand out. One is a lack of coordination among the malaria efforts worldwide—groups competing with each other in different areas. And I think the single biggest problem to the management of malaria is the lack of good governance in the developing world where there are civil wars, there’s hopeless abject poverty, there’s terrorism, there’s corruption. The control of malaria will require good public health measures.

What about malaria keeps you up at night?

Well, I guess there are two questions here: Keeps me up at night because I’m worried or keeps me up at night because I’m excited with the opportunity? Either way you lose sleep. Like any other manager of an institute, I have worries. We have generous funding, but it’s finite. Can we sustain this effort? Can we make accomplishments, move forward? On the other hand, most people my age—I’m 61—they’re thinking about retirement or vacation homes. I still feel like there’s a lot of passion. I can’t think of anything more important for someone like myself to get involved in. If things continue to go well, I plan to retire when I’m 99 [laughs].

Ever regret shifting your focus to fighting a disease that’s global, parasitic and so well-entrenched in mosquitoes and humans?

There is no regret. This is the job of a lifetime. It’s rare, I think, in anyone’s professional life when they have the kind of sense in their hearts that I do, that this is absolutely the right thing to do. And while I’m pleased how things have gone over the past three years, I sense we’re just beginning. They can fire me anytime, but I won’t go out willingly.