Malaria Control: Better Health, Better Future 2016 – Eradicate Malaria for Good
Following on from the World Malaria Day (WMD) celebration initiative and the subsequent commitment by SCI in 2015 to be part of the global millennium development goal to eradicate malaria, this year’s theme is “Eradicate Malaria for Good”. The millennium development goal is to decrease malaria by 90% by 2030. In spite of the encouraging decrease in malaria cases in certain areas (ALMA, 2016) this time frame is very ambitious, however efforts and support from the SCI international multidisciplinary pool of expertise is a very realistic glimpse of hope towards contributing to the global efforts and commitments to alleviate the burdens of malaria.
The current first line of treatment of malaria during the asexual life cycle of the parasite is artemisinin based combination therapy (ACT) where artemisinin derivatives dihydroartemisinin, artesunate and artemether are administered together with other known antimalarials such as lumefantrine, mefloquine, amodiaquine, sulfadoxine/pyrimethamine, piperaquine and chlorproguanil/dapsone in order to decrease the possibility of malaria parasites developing resistance to the antimalarials administered especially the most deadly Plasmodium falciparum.
Antimalarial drugs target different stages of the asexual malaria parasite life cycle following the parasite’s infection into the human blood stream and liver by a female Anopheles mosquito. Image source: tmedweb.tulane.edu
In 2015, malaria treatment was given a boost by the award of the Nobel Prize in physiology and medicine jointly; with one half being awarded to Professor Youyou Tu, “for her discoveries concerning a novel therapy against malaria”. Although the term “discovery” is much disputed due to the fact that malaria has been in existence for centuries and traditionally treated locally in endemic areas; the scientific community does credit this great scientist in Traditional Chinese medicine research and development for having managed to extract artemisinin, which inhibits malaria parasite growth and is used to treat fevers in Traditional Chinese medicine, from wormwood (Artemisia absinthium). It is likely that there are several other antimalarial active ingredients yet to be discovered/extracted from other traditional local medicines from areas where malaria has always been endemic. Other encouraging news includes the return of chloroquine as a first line drug to treat malaria. Not that its use had disappeared; as the drug still works in many cases, but it was given a back seat in national malaria control programmes.
Vaccine development saw the announcement of RTS,S/AS01 (RTS,S) a malaria vaccine that has been developed through a partnership between GlaxoSmithKline Biologicals (GSK) and the PATH Malaria Vaccine Initiative (MVI), with support from the Bill & Melinda Gates Foundation and from a network of African research centres that performed the studies. However, this vaccine provided 35-50% protection on a small clinical sample and further clinical and research developments are required before marketing approval can be granted. On 29 January 2016, WHO released a position paper on the malaria vaccine calling for further R&D studies.
Unfortunately, malaria diagnosis has not changed much, with diagnosis still being reliant on microscopic observation of blood smears and the most popular Rapid Diagnostic Tests (RDTs) among national malaria control programmes. More research and development is required to improve malaria diagnostic tools that are affordable in endemic areas which take into account environmental local conditions including electricity power cuts and subsequent storage shelf time, ease of interpretation of results by individuals and healthcare workers and minimum false positives.
This is an abstract of the full article published in: Outlooks on Pest Management – June 2016 issue.
The full text of this article is available to subscribers of Outlooks on Pest Management.
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Authors: Dr. Mary Nnankya1 and Prof. graham Matthews2.
1Namba- Biotechs, UK and member of the SCI Biotechnology and Environment, Health and Safety group
2Imperial College, IPARC, Silwood, Ascot, Sl5 7Py, UK and member of the SCI Agrisciences group
Category: Public health
