Statement of B. Fenton Hall, M.D., Ph.D., and Anthony S. Fauci, M.D.,
National Institute of Allergy and Infectious Diseases
National Institutes of Health
On World Malaria Day 2016, the National Institutes of Health (NIH) recognizes the considerable gains that have been made in reducing the global burden of malaria and renews our commitment to conducting and supporting the cutting-edge scientific research needed to end the scourge of this devastating mosquito-borne disease.
Improved prevention and control efforts have helped to curb malaria’s impact worldwide. Since 2000, global malaria deaths have decreased by 60 percent, and new malaria cases have fallen by 37 percent, according to the World Health Organization (WHO). However, roughly half of the world’s population continues to be at risk for malaria infection. In 2015, 214 million new malaria cases and 438,000 deaths occurred—largely among African children under the age of 5 years.
The World Malaria Day theme this year is “End Malaria for Good.” The National Institute of Allergy and Infectious Diseases (NIAID), part of the NIH, is committed to supporting and performing the scientific research critical to achieving this goal. NIAID scientists and grantees are working to better understand the malaria parasite and its biology; examining how anti-malaria drug resistance develops and spreads; and conducting studies to develop novel diagnostics, treatments, vaccines, and vector management interventions and strategies.
Through its International Centers of Excellence in Malaria Research (ICEMR), a collaborative network of research centers established in 2010, NIAID is supporting an array of sophisticated, multidisciplinary research in endemic regions and strengthening local research capacity. A key research focus of both the ICEMRs and NIAID scientists is examination of the expanding spread of resistance to artemisinin, the primary drug for treating malaria. For example, a recent NIAID study found Africa to be at greater risk for drug-resistant malaria infections than was once thought, which could complicate efforts to prevent and eliminate the disease in that region. NIAID scientists had previously demonstrated widespread artemisinin resistance among malaria-causing Plasmodium falciparum (P. falciparum) parasites in parts of Southeast Asia. NIAID research in this area helped shape new WHO malaria treatment guidelines for Cambodia.
The continued spread of drug-resistant malaria is driving NIAID to find new and effective antimalarial drugs. NIAID is currently providing product development support for nine antimalarial drug concepts in clinical testing and participates in partnerships to speed research and development of new interventions. One novel antimalarial, DSM265, was shown in preclinical testing to kill drug-resistant malaria parasites in both the blood and liver. The investigational product, currently in clinical testing, holds promise as both a single-dose cure and to prevent infection. Another recent NIAID-supported study investigated experimental drugs that target the proteasome, a key protein complex that regulates cellular processes in the malaria parasite. In mice, the drugs inhibited parasite growth without causing side effects in the animal, suggesting that this protein complex could be the target for new antimalarial drugs.
Safe and effective malaria vaccines also could play a central role in controlling malaria. NIAID is supporting the development of numerous malaria vaccine candidates, 11 of which are in clinical testing. For example, NIAID scientists completed early-stage clinical studies in Mali of two investigational malaria vaccines, PfSPZ and the TBV malaria transmission-blocking vaccine. Further clinical trials of both vaccines are underway. NIAID-supported researchers also have used next-generation sequencing to help explain why the RTS,S malaria vaccine—the most advanced malaria vaccine to date—provided only moderate protection to vaccinated children. The findings could improve future malaria vaccine strategies.
In addition to the pursuit of new malaria treatments and vaccines, NIAID researchers are exploring innovative approaches to mosquito control and interruption of malaria transmission. In a 2015 study, NIAID-supported researchers used a gene-editing tool called CRISPR/Cas9 to genetically engineer mosquitoes, so that they do not transmit malaria-causing parasites. When the genetically engineered mosquitoes were mated with normal mosquitoes in a laboratory setting, they passed on the malaria-blocking trait to nearly 100 percent of their offspring. This new method represents an important advance for malaria control and prevention.
Eliminating malaria will require a vigorous and sustained effort. On World Malaria Day, we join our partners in reaffirming our commitment to a robust biomedical research program needed to control, prevent, and ultimately, eradicate this deadly disease.
B. Fenton (“Lee”) Hall, M.D., Ph.D., is chief of the Parasitology and International Programs Branch in the NIAID Division of Microbiology and Infectious Diseases. Anthony S. Fauci, M.D., is Director of the National Institute of Allergy and Infectious Diseases at the National Institutes of Health in Bethesda, Maryland.