B.F. (Lee) Hall, M.D., Ph.D., and Anthony S. Fauci, M.D. National Institute of Allergy and Infectious Diseases
The National Institutes of Health marks World Malaria Day 2013, which has the theme Invest in the Future: Defeat Malaria, by acknowledging the considerable toll the disease continues to exact in many parts of the world. We also renew our commitment to the research needed to better understand the disease process in malaria, find new ways to diagnose and treat people with malaria, control the mosquitoes that spread it, and prevent malaria through vaccination.
Although considerable progress has been made over the past decade in the fight to control, eliminate and hopefully eradicate malaria, far too many people continue to become sick and die from this mosquito-borne disease. In 2010, 219 million cases of malaria and an estimated 660,000 malaria-related deaths occurred globally, according to the World Health Organization (WHO). Sadly, the majority of these malaria deaths were among children in Africa aged 5 years and younger.
The WHO reports that 50 countries are on track to reduce their malaria incidence rates by 75 percent by 2015, in line with established global health targets. Although these data are encouraging, these countries account for a mere fraction of the world's malaria burden, which is concentrated in 14 other countries where 80 percent of malaria-related deaths occur. While wider provision of proven malaria prevention and control interventions has had a significant impact in curbing the number of new malaria cases, particularly in countries with high transmission rates, much more must be done to rid the world of this scourge.
The National Institute of Allergy and Infectious Diseases has worked to strengthen research capacity in the countries most affected by malaria, through the creation in 2010 of the International Centers of Excellence for Malaria Research Initiative. One example of the work being conducted through this initiative is that researchers in Africa and Asia are performing active surveillance among malaria patients to detect and slow the spread of parasite resistance to the first-line antimalarial drug, artemisinin. Artemisinin resistance has been detected in Cambodia, Myanmar, Thailand and Vietnam. If it were to spread to India or sub-Saharan Africa, the global public health consequences would be dire. Artemisinin-resistant malaria is a key reason why new and improved malaria drugs are needed.
Recently, NIH-supported researchers from 16 institutions around the world identified a new class of anti-malaria compounds that target multiple stages of the malaria parasite's lifecycle. One compound in particular-ELQ-300-inhibited parasites at the stage in which they cause human infection and disease as well as at the stage responsible for transmission by the mosquito. Preclinical development of the compound is continuing.
Furthermore, a Phase II clinical trial of the novel anti-malaria drug NITD609 is currently under way in Thailand, and another novel drug, DSM265, is planned for early stage testing in humans this year. Research involving both compounds is being conducted as an ongoing collaboration between NIH-funded scientists and the nonprofit Medicines for Malaria Venture.
NIAID researchers also are targeting the mosquitoes that spread malaria. In 2012, NIAID-funded researchers genetically modified naturally occurring bacteria in the mosquito gut, which largely inhibited the development of the malaria parasite in the mosquito gut and rendered the mosquitoes immune to infection. This research, although in its early stages, has promise for preventing mosquitoes from carrying and transmitting malaria-causing parasites to people.
NIAID is also doing research to help individuals most vulnerable to malaria infection. NIAID scientists are conducting studies to better understand the immunology and disease progression of malaria in pregnant women and young children, which could lead to new preventive tools and treatments. Additionally, researchers are also examining how malaria affects HIV treatments in co-infected individuals, a particular concern for those in sub-Saharan Africa.
A vaccine to prevent malaria remains a key goal. Currently, seven NIAID-supported vaccine candidates are being tested, including one using live, weakened malaria parasites delivered intravenously to prompt an immune response. Results from that early-stage clinical trial are expected this year.
Scientists and health care providers have made significant gains in the fight against malaria, but significant challenges remain. On World Malaria Day, we stand with our global partners to affirm our commitment to pursuing the research initiatives needed to control and eventually eradicate malaria.
For more information on malaria, visit NIAID's malaria website.