THE LAST BITE?

We are forever being told these days about the growing influence of China in the world and Western concerns about this. But the story you're about to hear is almost the opposite - how Chinese efforts to find a potential cure for Malaria are being thwarted by Western medical boffins.  Daily throughout the globe – the deadly mosquito borne decease kills a staggering 3,000 children and more than a million people each year. It appears that the west does not want to know about what could be a medical science miracle waiting to happen. Here is Nick Lazaredes.


REPORTER: Nick Lazaredes

I'm about to join a group of Chinese scientists on a remarkable journey. We're flying to the island of Moheli, the smallest and most isolated part of the Comoros archipelago, where I'll have the chance to witness a controversial medical experiment in action.

PROFESSOR SONG JIANGPING (Translation): All the governments and people around the world hope to eradicate malaria. But the reality is this has not happened.

But that could be about to change. The Chinese are attempting to eliminate malaria from Moheli with a highly unconventional approach - experimenting on an island population of human guinea pigs. They've already produced some astonishing results against the deadly disease.

PROFESSOR SONG JIANGPING (Translation): Chinese scientists and healthcare workers have pursued the mission of eradicating malaria for over 1000 years. From herbal medicine to chemical medicine, we have now found a good method.

While most of the world's experts insist a global cure is at least 40 years away, the Chinese team, led by Professor Song Jiangping, are claiming that they can do it in a decade.

PROFESSOR SONG JIANGPING (Translation): If malaria is eradicated in ten years more than 10 million lives will be saved.

At Moheli's tiny airstrip the Chinese researchers are warmly welcomed, and their strategy is being strictly enforced, much to the delight of Professor Song.

WOMAN (Translation):  Medicine of malaria, to aid eradication.

PROFESSOR SONG JIANGPING:  Very good, this is preventive of malaria.

Everyone who enters this island by Air or by Sea must swallow a special tablet formulated by the Chinese team – there are no exceptions.  It’s a key part of the contentious technique they’re using here, known as mandatory Mass Drug Administration – that’s causing a serious division between East & West

PROFESSOR SONG JIANGPING (Translation): Chinese scientists and Western scientists have a different way of thinking. We Chinese put emphasis on the results of practice. Western scientists focus on the process or what they call scientific evidence. Process is important. But can process discover or lead to innovation? Practice, not process leads to innovation - truth comes from practice.

It’s a practice that appears to have paid off….. Just months after starting the project in November 2007 – Moheli’s infection rate was slashed from 22 percent, to less than 2 percent  - all by a simple 4 tablet treatment…

PROFESSOR SONG JIANGPING (Translation): The Main task of our anti-malaria team is to search for and eradicate the source.

Here in their island laboratory, Professor Song Jianping is now leading dozens of his researchers in a final scientific assault on the remaining pockets of infection… hoping to declare the Island Malaria free before the year is out.

PROFESSOR SONG JIANGPING (Translation): Our immediate focus is to search for those 140 islanders who are carrying the parasites. As you can see here, these researchers are doing a wide range of screening. Those islanders found to be positive will need to take medication.

It’s a big day in the village of Wanani –the vice president of the Comoros - is coming to celebrate the Chinese achievements. This mountain village was one of the worst areas for Malaria on Moheli because of the mosquito infested jungle that surrounds it – but not any longer. On the edge of Wanani – the professor is keen to show me the village hospital which now stands empty.

PROFESSOR SONG JIANGPING (Translation): Before the project was carried out in November 2007, the hospital was crammed with malaria patients. Many were patients of malaria. Many children died of malaria in this hospital. Today there is not a single malaria patient in here. Today we’re very pleased to see good results using this method of rapidly killing malaria.

Professor Song Jianping says the dramatic success here is nothing short of a global breakthrough, and he's anxious to extend it to the world without delay.

PROFESSOR SONG JIANGPING (Translation): The Moheli project has been running for a year now and is problem free. The experience clearly tells us that malaria can be eradicated globally in a short period. No need to wait with so many lives and resources wasted. The key point is to take an active approach.

FATINOU WAFIK, MOHELI PUBLIC HEALTH DIRECTOR (Translation): We achieved fast results and we were all deeply moved by the speed with which the disease decreased.

Moheli’s Public Health Director, Fatinou Wafik is astonished at the Chinese progress. He says Malaria had long been established as the island’s deadly scourge.

FATINOU WAFIK (Translation): Throughout its history, Mohéli has experienced every form of malaria. And families have remained poor for many years, because it costs a lot of money to care for malaria sufferers.

The Island’s Malaria death toll has been at zero for more than a year – and Wafik’s convinced Moheli will soon become famous for its part in an extraordinary medical advance. 

FATINOU WAFIK (Translation): I think we deserve observation. It is my hope that Mohéli will become a shining example for the rest of the world. I’m not dreaming. This is the same ambition that made us declare war on malaria. So today I can also claim the right to dream that Mohéli will become an important reference point worldwide.

The astonishing results achieved in the Comoros trace their origins here - to the University of Traditional Medicine in Guangzhou, and to this man, Professor Li Guoqiao, one of China's leading authorities on malaria. His research began in an effort to help communist troops during the Vietnam war, the result was a drug based on a traditional herb identified 1,600 years ago by a Chinese doctor.

PROFESSOR SONG JIANGPING (Translation): His name was Ge Hong. In this book he clearly sets out a prescription for Artemisinin. It reads “Squeeze an Artemisinin plant and drink its juice. “This can cure malaria.”

By studying this plant the Chinese were able to identify what the world now knows as Artemisinin, the most effective cure for malaria. On Moheli, Prof Li's team are using a powerful combination of Artemesinin with two other drugs, and while expanding their achievements from a tiny island to an entire continent like Africa might seem fanciful, Professor Song Jianping is convinced that with enough money and coordination it will work, despite the sceptics.

PROFESSOR SONG JIANGPING (Translation): They said, okay, malaria could be eradicated on a small island, or that could even be done on a larger island.  But the problem is that Africa is a huge continent. So I replied with a joke. If you are in a satellite, looking down at the earth, Africa will become an island. The same anti-malaria project can apply anywhere. The main thing is to have it done properly. It’s the same logic.

To that end plans are well under way to extend the experiment to the rest of the Comoros, and then to its much larger neighbour, Madagascar.

But the Chinese effort to expand their bid to eliminate malaria has encountered a major hurdle, and one that threatens to kill off the global roll-out of the new Artemesinin-based medication. And it's not logistics or money that's standing in their way, but the world's largest public health authority, the W.H.O.

DR KASANKOGNO, W.H.O. REPRESENTATIVE:  This strategy is not internationally recognized – and it is why W.H.O. is not directly part of this.

While the Chinese believe they're on the edge of an international breakthrough, the World Health Organisation is not convinced. Its representative in the Comoros, Dr Kasankogno, says their testing hasn't been thorough enough.

DR KASANKOGNO:  It went through 3 steps – it didn’t go through the 4th steps, and now as it didn’t go through the 4th step we are not, W.H.O. didn’t recognize this drug.

REPORTER: Now for some people looking at the situation, they would consider it quite strange that the WHO has no direct contact with the Chinese. Why is that?

DR KASANKOGNO: Yes, because if the drug is not recognized and we go within the team, and they didn’t follow the W.H.O. regulation on the drugs, and after some years there is a problem, they will say –It’s W.H.O.’s job.

SIR RICHARD FEACHEM, PROFESSOR OF GLOBAL HEALTH, BERKELEY UNIVERSITY:  This particular approach being used in the Comoros has never been written up or published in a peer review journal, so it hasn't seen the light of day, through that important mechanism.

Sir Richard Feachem is one of the world's leading figures in the struggle against malaria.

SIR RICHARD FEACHEM:  Experts in this room will differ, but my hunch is we're talking about 2050, 2060 - something like that. That's about the time we can hope to see a malaria-free planet.

Last month he kicked off the Asia-Pacific Malaria Initiative in Brisbane, addressing some of the region's top experts. But Professor Li and his team from Guangzhou weren't invited. While the Chinese claims might excite the public imagination, western scientists remain unimpressed.

SIR RICHARD FEACHEM:  Interesting. Anecdotes are interesting – they incite the curiosity – this sounds rather good, tell me more – is the reaction I think to these reports – but it falls short, it falls way short of a peer review journal scientific publication, and that’s really what we need now.

While the Chinese team haven't published any results yet, they're still collecting data and trying to stamp out the final traces of malaria on Moheli.

PROFESSOR SONG JIANGPING:  1 hour the person stay in the house here, and 1 hour out they stay outside, like this.

REPORTER: So they get the Mosquitos from inside and outside?

PROFESSOR SONG JIANGPING: Yes.

I've joined them at night as they travel around almost every village on the island collecting mosquitoes from volunteers who wait to get bitten.

PROFESSOR SONG JIANGPING: If the Mosquito is here – the person he know the mosquito is here – and he take this – and use some cotton – and keep here. Anophel, anophel, ….they take 12 mosquitos and 4 of them anopheles.

They’re looking for the type of Mosquito called anopheles – the only species to transmit malaria.  Village by village, night after night, the Chinese are hoping that their painstaking efforts will satisfy the meticulous standards of western scientists.

PROFESSOR SONG JIANGPING: This result will be very, very scientific, very, very exact.

REPORTER: So this should be a quite acceptable result for the world health organization?

PROFESSOR SONG JIANGPING:  I hope so.

The catalyst for this East-West division came when the WHO learned of their plans to use Artemisinin en masse in the Comoros.

PROFESSOR SONG JIANGPING (Translation): Because it was a new technique, many experts were doubtful when it was first introduced. To them, it would be impossible to eradicate malaria. They thought that could only be an illusion, a dream.

One of the WHO's biggest concerns was that Artemesinin's use in a mass campaign might lead to the emergence of a resistant strain of the disease, and that would mean the best anti-malarial known to man would be lost forever.

PROFESSOR SONG JIANGPING (Translation): They agreed that, Aartemisinin was a very good drug. But because it was such an excellent drug, it couldn’t be used in Africa as the frontline drug. If the best drug was used, what would be left for them to do?

 REPORTER: Is there a concern that this drug that they're using, that there could be some resistance problem? Or is that not an issue with this drug?

DR KASANKOGNO: Myself, I am a little concerned because the strategy is at the starting point – they will give a full treatment. After, it will be a prevention, which means that there is a minimal dosage, and with all the drugs in the world, when you have a minimal dosage, there is a risk, I’m not sure, but there is a risk that there will be resistance…

While it's quick to criticise, the WHO itself is far from blameless when it comes to malaria resistance. In 2004, almost a dozen of the world's leading malaria scientists wrote a stinging article. In it they accused the WHO of approving cheap medicines that were increasingly ineffective, allowing drug-resistant malaria to thrive. With their competency under fire, there was a swift response.

At the time, Sir Richard Feachem was head of the Global Fund, the world's single biggest financer for efforts to fight malaria. The fund was also accused of complicity in the mono-therapy scandal, but Feachem says it was an important turning point towards combination therapy.

SIR RICHARD FEACHEM: In a very short period of time, something like 80 countries changed policies, made new requests to the Global Fund and the world changed very rapidly. I mean, I've never known it in my history of international public health - such a rapid, large-scale shift from one type of treatment to another type of treatment.

Despite the West's mistakes just a few years ago, Sir Richard cuts the Chinese little slack. He says until their results are published in scientific journals their claims are worthless.

SIR RICHARD FEACHEM: There are reasonable standards of evidence in the medical and public health world, and they're important standards, because they protect the public from dangerous and hurtful things being done to them in the name of science or medicine.

Professor Song says it's a typical response from Western scientists.

PROFESSOR SONG JIANGPING (Translation): During our Artemesinin research, we embarked on a bumpy road in our international exchanges. You may say that we’ve suffered many setbacks. They didn’t believe whatever we said. No one believed us. Even if we had done a great job, they still didn’t believe us. The reason is that many of them look down upon us Chinese.

Back in the village of Wanani, no-one is looking down on the Chinese efforts. Here the scientists are guests of honour, and the Comorians are giving Islamic prayers of thanks for eradicating malaria from the village. Officials from the WHO are also here handing out mosquito nets to every family in the village to ensure that malaria doesn't return. But there's one more gift in store for these poor villagers.

The Chinese have paid for water to be piped up the mountain and into the village. It's a sign of their long-term commitment here.

TAO WANG, AMBASSADOR, CHINA (Translation): The Chinese government genuinely wants to do some practical things for the people of Africa.

China's Ambassador to the Comoros, Tao Wang, is among today's guests. He says China's growing role in Africa is viewed with suspicion in the West, and that's fuelling the criticism of the malaria team's achievements.

TAO WANG (Translation): They don’t want to see China developing and growing. They don’t want to see China having a big impact in Africa or other countries. They even fear that China’s growth and increasing impact may affect the influence they currently have in African countries.

But the world’s malaria experts insist that no one has closed the door on the Chinese efforts.   In fact, in a sign that augurs well, Sir Richard Feachem has agreed to fund the translation of thousands of pages of Chinese research into English.

SIR RICHARD FEACHEM: We have indeed had up to now an inadequate communication caused by language – very easy to understand, and we’re certainly very committed to bridging that – because we’re absolutely convinced that there’s a wealth of evidence and knowledge in China that the rest of the world can benefit from.  

While Feachem is taking tentative steps to bridging the gap, so, too, are the Chinese. They expect to publish their results in a Western journal soon, and they're hoping their approach will be vindicated, saving millions of lives, and earning the people of Moheli a place in history.

PROFESSOR SONG JIANGPING (Translation): We hope and we request that governments, organisations and people around the world will all join in this great cause of eradicating malaria. It’s a sacred cause. It’s a cause that will benefit future generations

Reporter/Camera

NICK LAZAREDES

Additional Camera

ADRIAN BROWN

Researcher

VICTORIA STROBL

Fixer

AHMED ABDALLAH

Editors

NICK O’BRIEN

MICAH McGOWN

Producer

AARON THOMAS

Translations/Subtitling

MARIAMA MMADI

JING HAN

GEORGE BURCHETT

FELICITY MUELLER

Original Music composed by

VICKI HANSEN