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In the past decade, the world has made impressive progress in the fight against malaria. Now, experts at a panel discussion moderated by PATH President and CEO Dr. Christopher J. Elias said, we need new tools to sustain and even expand the gains.

The March 21 discussion, sponsored by PATH, the Global Health Technologies Coalition, and the Medicines for Malaria Venture, focused on the current state of malaria research, the role of donors in supporting research, and the promise of new, lifesaving tools.

Malaria experts from PATH, Medicines for Malaria Venture, PATH’s Malaria Vaccine Initiative, and the President’s Malaria Initiative discussed research, the role of donors, and malaria-fighting tools on the horizon.

New tools, continued progress

Over the past three and a half years, existing tools—such as increasingly effective means of diagnosis and insecticides that prevent malaria transmission—had prevented malaria in some 700 million people, Ray Chambers, United Nations special envoy for malaria, told an audience at PATH’s Washington, DC, office. The number of people who have contracted malaria has dropped dramatically, Chambers said, and the number is continuing to fall.

In many countries, the number of people who die from malaria is falling as well. In 11 malaria-prone countries, fewer than half the people who get the disease die from it. In one region, Zanzibar, the malaria mortality rate is approaching zero. By 2015, Chambers is hopeful that the rate will fall to zero worldwide.

Chambers said success would be impossible without the involvement of many partners, including the World Health Organization, the President’s Malaria Initiative, the Bill & Melinda Gates Foundation, and actors in the private sector.

More drugs for the pipeline

Dr. David Reddy, CEO of the Medicines for Malaria Venture, said that partnership—between the private sector, donors, multilateral organizations, academia, and governments—is integral to the success of malaria control efforts. He said delivery of high-quality drugs to the people who need them most is still a challenge. Artemisinin-based combination therapy, for example, has proven effective, but the treatment is meeting only about 20 percent of the current need.

Moreover, Reddy said, in areas such as Southeast Asia that are encountering forms of malaria resistant to artemisinin, development of new combination drugs is crucial. “Safe and simple” drugs with minimal side effects—such as a single-dose pill—are needed in the fight to eradicate malaria. When such drugs become available, Reddy said, it is imperative that global regulatory processes ensure people have access to them.

The promise of new vaccines

Vaccines also hold promise. The most clinically advanced malaria vaccine candidate is now in large-scale, phase 3 clinical trials, said Dr. Christian Loucq, director of PATH’s Malaria Vaccine Initiative. The trial is proceeding with 15,460 participants from two different age groups—young children, aged 5 to 17 months, and infants, aged 6 to 12 weeks. Initial results from the study are expected in late 2011 for the young children and in late 2012 for the infants. Final analysis is expected in 2014.

Loucq noted that the Malaria Vaccine Initiative is investing in other promising approaches, including transmission-blocking vaccines that would prevent transmission of the malaria parasite from mosquitoes to humans. Used in combination with other interventions, Loucq said, this type of vaccine could be a critical tool in achieving the ultimate goal: malaria eradication.

Keeping up the momentum

Rear Admiral Timothy Ziemer, US global malaria coordinator for the President’s Malaria Initiative, pointed to PATH’s Malaria Control and Evaluation Partnership in Africa as a program notable for its effectiveness. But while acknowledging recent progress against malaria, Ziemer warned against complacency. Congress, he said, must be encouraged to maintain vital funding for malaria control efforts as well as to accelerate investment in research and development.

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Posted April 13, 2011.