Non lethal pathogenic diseases: Changing the paradigm from a zero sum game to a symbiotic relationship, the case of malaria

Abstract

Non-lethal Pathogens that present with a long human co-evolutionary history,  may be reasonably expected to be more genetically diverse with a greater propensity to create resistant variants in response to vaccine deployment.  Conversely, their human hosts would be expected to generate Darwinian balanced polymorphisms against parasite invasion that mitigate damage to both, host and parasite alike. Selection of foods represents one of the most obvious routes for cultural adaptations to disease. In the case of malaria, so stark is the effect of food ingredients, that they can actually reverse malaria protective hemoglobin variant genotypes. In addition to the current paradigm of IC₅₀ screening, which can produce parasiticidal drugs with the ability to save lives, yet with short clinical life spans; it is worthwhile to superimpose a knowledge of the Darwinian evolutionary trajectories of the host and the parasite on the drug development process to help select molecular targets and/or pathways that would be less amenable to the development of drug resistance. Altered drug screening procedures involving a multitude of molecules such as those typically found in extracts could prove worthy of this proposed ‘evolutionary drug design’ paradigm. Existing malaria eradication policies should be revisited and re-examined, with a view to working with – rather than against – natural selection.