Net access aids malaria study

Malaria is one of the toughest diseases for scientists to battle because it is most prevalent in remote areas of Africa, where electronic communications are either outdated or nonexistent.

Villages such as Ifakara and Amani in Tanzania, a country on Africa's east coast that borders the Indian Ocean and is more than twice the size of California, are ravaged by the disease, in large part because it is so difficult for the medical community to reach those isolated locations. The only road to Ifakara, which doesn't have a single telephone, is impassable during the rainy season. And Amani, located on a hillside 1,000 meters above sea level, has just one telephone — a hand-cranked type that works sporadically.

So how can scientists working in those remote spots help develop a vaccine for malaria if they can't easily share their findings with other researchers?

A new program being led by the National Library of Medicine, part of the U.S. Department of Health and Human Services, is making a difference. As part of its Multilateral Initiative on Malaria (MIM), NLM created a real-time, satellite-based research network for scientists working in Africa.

"There are some areas in Africa where people get one infected bite per night, and there is nowhere else better than there to research," said Mark Bennett, the main technical consultant for the project. "By putting the Internet in there, [scientists] can perform much better, leading-edge [trials] wherever they're willing to go because they know they will have access, can publish remotely and are not replicating research done elsewhere. They can interact a great deal more easily and turn things around much quicker."

The MIM network is up and running — complete with access to the World Wide Web and e-mail — in five research sites in Kenya and Ghana. Researchers in Ifakara and Amani will have access to the network beginning next month.

The Centers for Disease Control and Prevention and Redwing Satellite Solutions, a telecommunications company located near London, are helping foot the bill for the MIM network. NLM is mainly responsible for project oversight, network installation and trouble-shooting.

"The [NLM] feels very strongly about cutting off a significant piece we can handle and doing it well," said Julia Royall, a special expert appointed by NLM to head the project. "Africa is an interesting, but very challenging place to work, and you can't set a lot of goals. Sustainability and partnership are the big words for us."

Royall and NLM hand-picked Bennett for the project because of his previous experiences in helping to establish Internet connectivity in parts of Africa where none previously existed.

Bennett has more than 15 years experience in telecom projects on the continent, including 12 years as systems manager and then director of the computer center at the University of Zambia. While there, he established ZamNet Communication Systems Ltd., the first Internet service provider in sub-Saharan Africa outside of South Africa, before relocating back to England in late 1996. Bennett is currently based in Cambridge, where he launched AfriConnect, a consulting firm that specializes in African telecommunications projects.

Bennett masterminded the strategic plan that made connecting the remote locations feasible and affordable. He simplified the network design and minimized the amount of space required to support the remote sites through the use of very small-aperture terminals. VSATs use satellite ground systems, one to three meters in size, located at each site (see "Out of Africa").

"There is huge potential for this kind of technology in Africa," Bennett said. "It's new, but it's extremely appropriate because there are no copper-wire phone lines in much of Africa, and half the people there have never touched a phone — and never will. People are already contacting us about getting into the systems that are going up, but the question is the rate to do it so it remains sustainable."

Bennett said he is confident that the network will have a significant impact on the development of a vaccine for malaria — a disease that attacks the body's red blood cells and can be fatal without proper treatment. Only certain types of mosquitoes, which are found worldwide in countries with tropical and subtropical climates, spread the disease.

"You can't trial vaccines without a very quick way of getting back to the people [who] are working on the drugs," Bennett said. "If you have Internet connectivity, you can send images, slides and descriptions of results immediately, and that can only really be done over the Internet."

Another benefit of the program is that it is "strengthening the capacity of the African researchers," Royall said. "Researchers from the U.S., the U.K. and Europe set up outposts and then go home. This is about empowering folks who are there to make a change in health in the cities, which is not always a strong interest of outsiders."

Royall said future research will be done to determine the impact of information technology on the morbidity and mortality rates of malaria in Africa.