The University of Pretoria Institute for Sustainable Malaria Control (UP ISMC) turns 10 on 12 May 2021. Primarashni Gower spoke to the institute’s Director, Professor Tiaan de Jager, who is also Dean of the Faculty of Health Sciences.

PG: Why was the UP ISMC established and whose idea was it?

TdJ: The UP ISMC was strategically established as a transdisciplinary research platform to promote innovative, collaborative research within the University on safe, sustainable malaria control and management strategies in Africa. The idea to start a centre (at that time) came about from discussions between myself and Prof Walter Focke of the Department of Chemical Engineering. At the time, I was looking at the health impact of insecticides used for malaria control, and he was developing insecticide-containing polymers as safer vector control tools. There was a shared common goal to combat malaria without risking human health. It made sense to start a research entity focusing on malaria, and inviting other UP researchers to collaborate.

PG: How many academics were originally involved and how did it grow?

TdJ: At inception and at the official launch in November 2011, there were 18 researchers from departments in four of the UP faculties involved. Ten years later, the institute has expanded to more than 40 affiliated researchers from different disciplines and their postgraduate students, across all nine UP faculties and the Gordon Institute of Business Science; all these individuals are working on malaria-related projects. Additional expertise was also brought to the table through external collaborations.

PG: Tell me about the research.

TdJ: Each researcher within the institute has his/her own area of expertise, and all aspects of the disease are addressed in some way. Research is grouped into three clusters – human health, parasite control and vector control – with research occurring in and across clusters. This allows for a holistic look at the challenges associated with malaria and how best to control and eliminate the disease through novel and innovative approaches. 

PG: Which are the worst-hit areas in South Africa and why is this the case?

TdJ: The north-eastern parts of Limpopo, Mpumalanga and KwaZulu-Natal are malaria-endemic, with 10% of the country’s population at risk of contracting the disease. The northern parts of Vhembe District in northern Limpopo have the highest malaria incidence and prevalence in South Africa, and account for about 60% of the country’s malaria burden. The region has the perfect climatic conditions for both vectors and parasites, which are dependent on high ambient humidity, good rainfall and relatively warm temperatures to thrive, as well as a large human pool in a poor rural setting for the mosquitoes to feed on.

PG: Which species of mosquito is responsible for the spread of malaria?

TdJ: Malaria is caused by Plasmodium parasites, which are transmitted to humans when bitten by infected female Anopheles mosquitoes. There are approximately 530 Anopheles species worldwide and only 30 to 40 are vectors of medical importance in humans.  

PG: Why is it difficult to eradicate malaria?

TdJ: Malaria control strategies focus primarily on controlling the vectors and parasites.  There are, however, many challenges. The most important is the complexity of the malaria lifecycle, which consists of three biological components and their complex interactions. The situation is further exacerbated by a combination of challenges, including drug and insecticide resistance; human movement within a country or across borders and introducing new parasite strains; climate and climate change that can lead to new endemic areas or reintroduction of malaria in previous malaria-free areas; changes in vector biting behaviour; malaria control strategy implementation challenges; and the limitation in funding available to control the disease. 

PG: What are the socio-economic effects of malaria?

TdJ: Malaria is recognised as a disease of poverty. It drastically impedes socio-economic growth and development (up to 30% in Africa), especially in the poorest countries, by impacting adversely on the existing poor quality of life in malaria-endemic communities. These communities are often based in large rural settlements with poor living conditions, terrible malnutrition and inadequate access to healthcare. Add malaria to this mix and the situation is just made worse.

PG: What are some of the UP ISMC's major achievements?

TdJ: Some major achievements include the awarding of a DSI/NRF SARChI Chair on Sustainable Malaria Control. The UP ISMC was also awarded SA-MRC Collaborating Centre of Malaria Research status. Furthermore, the institute hosts a DSI/NRF Community of Practice (the first at UP) in Malaria Elimination, led by Prof Lyn-Marie Birkholtz in the Faculty of Natural and Agricultural Sciences, which draws on the expertise of six SARChI Chairs from four top research-intensive universities in South Africa. The UP ISMC team also won a 2017/ 2018 National Science and Technology Forum (NSTF)-South 32 award.

PG: Tell me more about your NSTF-South 32 award. 

TdJ: We received the NSTF Award for ‘Communication for outreach and creating awareness of science and engineering technology (SET) and innovation by a team or individual over five years’. The award highlights the institute’s commitment towards raising awareness about the disease and our malaria research, especially in affected communities. Education and health promotion relies on a collaboration between researchers and the community, and are important aspects of malaria control. The institute has strong community ties in Vhembe through its local citizen scientists, trained by our researchers, who aid in communicating all aspects of our research to the local community.

PG: Which organisations does the institute work with?

TdJ: Collaborations exist between the UP ISMC and its partners from various tertiary and research institutions, both nationally and internationally. This includes the South African National Space Agency and French National Space Agency; industry; parastatals, such as the South African Weather Service; and governmental departments. Our research is aligned with the Department of Health’s malaria elimination strategy, and researchers work directly with the provincial malaria control programmes, and the affected malaria-endemic communities.

PG: Why did you take a personal interest in malaria?

TdJ: My research focus is on endocrine disrupting chemicals, reproductive toxicology, public and environmental health. I developed a special interest in malaria due to the impact of malaria control insecticides on male reproductive health, and thought it both important to create awareness about the dangers of insecticides, but at the same time to search for alternative and safer control methods.

PG: Do other universities in South Africa have a similar institute?

TdJ: Other universities in South Africa are working on selected aspects of malaria – however, the UP ISMC focuses on all aspects of the disease, making it unique in its integrated approach. We also welcome anyone, regardless of their background or expertise, that wants to collaborate on malaria research. Essentially, the institute offers a glimpse of what transdisciplinarity in action looks like.

PG: Where to from here, Prof?

TdJ: There are several existing plans in the institute’s future, including a foray into management and leadership capacity building in Africa’s malaria control programmes, collaboration on the University’s One Health research platform, and continuing the search for innovative and creative ways to tackle malaria. Our researchers remain committed to contributing towards a malaria-free Africa through transdisciplinary research.