George Clooney got malaria in Sudan. Now him and buddy Nicholas Kristof have a
Q&A on the disease at NYTimes.com. I tried not to be cynical. I thought it would be a cute, gimmicky way to draw attention to an important disease, and perhaps dispel some myths along the way. Unfortunately, they ended up creating some along the way instead.
The answers range from harmless:
What side effects did you have? And what were your symptoms when malaria was detected?
— Gayle
A.
Not much in side effects, the symptoms are fever, the chills, and exciting adventures in the toilet..weak..really just very bad flu conditions with a little food poisoning thrown in to make you the perfect party guest.
To mildly dim:
George – A dear friend of mine had malaria…does it recur? And if you’ve had it once, can you get it again?
— BrazenMuse
A.
It can…it depends on what type you get..i didn’t get that strain thankfully.
— George Clooney
[Big aside: The number one reason malaria reoccurs is inadequate treatment, meaning all the parasites were not killed in the first place. Old treatment regimes caused the parasite to "retreat" to the liver, rather than fully killing it. Today, when malaria is treated with drugs that it has developed resistant to, or treated incompletely (with a partial course), malaria can reoccur. Many drugs available to treat malaria experience partial parasite resistance, but are still used either because they are effective first line treatments (in an area of incomplete parasite resistance), or because they make the symptoms go away, encouraging clinicians and patients as to their effectiveness. Recurrence is
more common in certain strains, but usually because these strains have delayed symptoms, causing malaria to not be treated or to be treated inadequately, or high rates of drug resistance.
Adequate, complete, and timely treatment can prevent malaria recurrence in almost all cases (except in the case of reinfection, which is also quite common). Malaria recurrence despite adequate treatment is treatment failure, in which case second-line treatments are deployed.]
To foolish and misleading:
George – How did your treatment for malaria differ from the treatment that the average Sudanese would receive?
— Joy F.
A.
I had drugs to take before during and after…pills that should be just provided to these people, like a polio vaccine..life saving drugs for diseases that kill millions needlessly, belong to mankind not to companies to profit from….we need another Jonas Salk.
— George Clooney
OK, first of all, I don't know what he means by "before, during, and after." If by the "before" part he is referring to prophylaxis pills, then, no, these wouldn't be available to the typical Sudanese, because prophylaxis pills aren't meant to be taken for a long period of time. They're essentially ongoing treatment for malaria, which kills the parasite immediately in case you contract it--the liver has to work over-time to process these pills, and they have to be taken daily or weekly. Ongoing prophylaxis use in endemic areas is medically inadvisable, financially unsustainable, and logistically infeasible.
Let's move on to the next part of his response: "life saving drugs for diseases that kill millions needlessly, belong to mankind not to companies to profit from." I agree, the sentiment sounds nice. It's just a matter of wresting the life-saving drugs from the evil pharmaceutical companies, and all our problems are solved! It certainly sounds much nicer than, "How do we sustainably ensure supply, distribution, and use of lifesaving technologies in a constantly changing disease environment, where even free commodities face take-up challenges?" Unfortunately,
that's the actual problem at hand.
