12 Jun 08

Professor François Nosten

The €400,000 prize is awarded annually to a researcher or research team studying infectious diseases in developing countries, and is presented by the Institut de France.

Professor Nosten is Director of the Wellcome Trust-funded Shoklo Malaria Research Unit (SMRU) in Thailand, part of the Oxford University Centre for Tropical Medicine.

’I'm delighted to have received this award,’ says Professor Nosten. ’The recognition from my home country for the work of myself and my colleagues is very important, and the prize money will allow me to conduct more work on maternal malaria, a poorly-researched area.’

Malaria is one of the world's deadliest killers. Caused by Plasmodium parasites, it kills over a million people each year, mainly pregnant women and young children in Africa and south east Asia. Although treatments exist to tackle the disease, until Professor Nosten's work, little was known about how to treat pregnant women, particularly in areas where the parasites have been increasingly developing resistance to treatment.

’Pregnant women are always excluded from clinical trials because of the fear of harming the unborn baby,’ explains Professor Nosten. ’Paradoxically it was considered unethical to recruit pregnant women in studies, but ethical to leave them untreated.’

Professor Nosten, together with Professor Nick White, began researching maternal malaria over 20 years ago on the border of Thailand and Burma where they saw many pregnant women dying from malaria. By organising antenatal consultations for all pregnant women to screen their blood every week during the pregnancy, they were able to detect malaria parasites quickly and treat them before they developed into severe infection.

’The antenatal screenings were very time intensive, but the system worked beautifully,’ says Professor Nosten. ’The number of pregnant women dying from malaria fell from one death per hundred live births to zero.’

The success of their approach enabled the team to focus on the prevention and treatment of malaria in pregnant women, and area where very few studies had previously been conducted. Professor Nosten and colleagues have undertaken most of the clinical trials looking at the best treatment options. They found that pregnancy alters the efficacy of antimalarials and that the doses of medicines given to pregnant women were too low. Their work has led to a revision of guidelines produced by the World Health Organisation (WHO).

Professor White says: ‘François and his team work in very difficult circumstances, yet they have produced some of the most important research on the treatment of malaria, which has led to a global change in treatment recommendations. They have conducted pivotal work on the epidemiology, pathophysiology and treatment of malaria in pregnancy, and changed the way it is treated.’