This month, three big scientific advances were announced at the MIM Pan-African Malaria Conference. All of them are bad news for malaria. Each of these advances has the potential to strengthen the fight against malaria over the next decade and help us to eliminate this disease. Here’s the rundown:
1. A malaria vaccine success in Stage 3 trails
After more than 20 years in development, RTS,S is the first potential malaria vaccine to advance to Stage 3 trails. PATH Malaria Vaccine Initiative, GlaxoSmithKline (GSK), and 11 African research centers in seven countries presented the latest results from the ongoing Phase 3 trial on the RTS,S malaria vaccine. Over 18 months, the vaccine was shown to almost halve (46%) the number of malaria cases in young children (aged 5-17 months). In infants aged 6-12 weeks, malaria cases declined by about one quarter (27%). This vaccination is still under development and further results of the ongoing trail will be made available next year. And, GSK plans to submit the vaccine for regulatory approval next year.
Why it is important
To date there is no vaccine for malaria. The malaria parasite is more complex than bacteria and viruses, which are usually targeted by vaccines. This makes developing a vaccine a challenge. Nonetheless, the RTS,S vaccine has demonstrated that this is possible and that a vaccine can provide a significant level of protection for at least a year and a half. Considering that malaria infects approximately 219 million people each year, the number of cases, and consequently deaths, averted by the RTS,S vaccine would be substantial.
Other vaccines are in the pipeline, including the PfSPZ vaccine that is under development by Sanaria, the Naval Medical Research Center, and the National Institutes of Health, and shows a much higher efficacy in Stage 1 trials.
2. Eight new compounds that kill
The IVCC (Innovative Vector Control Consortium) announced that it has identified more than eight new compounds that can kill insecticide-resistant mosquitoes. Three of these will be selected for further development, including rigorous environmental and safety testing. These insecticides may be available on the market as early as 2020.
Why it is important
Bed nets and indoor residual spraying are responsible for much of the decline in malaria in sub-Saharan Africa, and bothuse insecticides to kill mosquitos. Bed nets contain insecticides in their fabric. Indoor residual spraying uses persistent insecticides to treat the interior walls of houses and protect the families that live inside for up to six months. Over time, mosquitos develop resistance to the insecticides used to fight malaria. Having three different insecticides to use in a coordinated manner will limit the ability of mosquitos to develop resistance to any individual product.
3. First-ever antimalarial drug compound developed on African soil is on the move to human trials
After a year in development, a new antimalarial compound, MMV390048, is moving to human trials. Discovered in 2012 by researchers with the Drug Discovery and Development Centre (H3-D) at the University of Cape Town, South Africa, the drug is the first to be developed in Africa – for any disease.
Why it is important
Malaria parasites have developed resistance to every drug that has ever been widely and effectively used to treat infections in humans. Chloroquine, Fansidar, and Amodiaquine were each highly effective and valued as anti-malarial drugs. Each of them failed over time. The result was devastating; the number of severe malaria cases and deaths increased without the availability of drugs that could effectively treat the disease.
In Southeast Asia, some malaria parasite resistance has been detected to Artemisinin, the main active ingredient in the current first-line anti-malarial drugs called Artemisinin Combination Therapies (ACT). Efforts are underway to stop the spread of these resistant parasites. The development of a new antimalarial drug formulation is crucial to ensuring that effective treatment will be available should resistance become a widespread problem.