NIAID has a long history of supporting research and development activities to provide more effective strategies for controlling malaria. These activities include both basic and applied research on the parasite basic biology, pathogenesis, immunology, and epidemiology, as well as clinical research to develop novel drugs, diagnostics, and vaccines. The Institute has developed both the NIAID Strategic Plan for Malaria Research and the NIAID Research Agenda for Malaria.
Despite advances, malaria remains a leading global public health concern. In fact, more than 40 percent of the world’s population lives in malaria-endemic regions. Control efforts have been effective in some areas but not very successful in others. This inconsistency has been associated with the emergence and spread of parasite drug resistance and insecticide-resistant mosquitoes.
Sustainable and effective malaria control requires better understanding of the complex interactions among the parasite, the mosquito vector, and the human host. Recognizing the urgent need for a multidisciplinary approach to address these complex interactions at the molecular, cellular, and field levels in malaria-endemic regions, NIAID established the International Centers of Excellence for Malaria Research (ICEMRs) in 2010.
In 2010, ten seven-year awards were made with the aim of conducting research in approximately 20 countries and at more than 50 field sites. The Centers conducted research on: risk and transmission of malaria in humans and vectors; pathogenesis; parasite and vector genomics; human, ecological and environmental factors affecting the spread of disease; and molecular epidemiology influenced by the complexity and intensity of disease transmission.
The 2010 ICEMRs led to many major research findings and more than 370 original research articles. Important projects from the ICEMR program include:
- A study that showed that current rapid diagnostic test strips being used in the field are failing since the malaria parasite, in many settings, is not expressing the antigens that the strips are designed to detect.
- Research that shows a significant shift in the behavior of Anopheline mosquitoes. Malaria is transmitted by mosquitoes biting indoors, late at night. More mosquitoes now appear to be biting outdoors and earlier in the evening, when people are not sleeping under bed-nets.
- Genomic research that has resulted in a large number of genetic sequences of parasites and mosquitoes. Many sequences are now available in the public domain, and researchers can use this information to develop the next generation of drugs, vaccines and diagnostics.
In March 2012, the journal Acta Tropica published a special supplement issue focusing on the ICEMRs, titled "Tackling the Malaria 'End Game': Regional Needs and Challenges for Successful Malaria Elimination." The supplement began with a foreword by Malla Rao, Ph.D., ICEMR Program Director and Deputy Branch Chief of the NIAID Parasitology and International Programs Branch. The foreword is followed by articles describing the preliminary research being conducted at each ICEMR, which provide baseline information about each region that will help to inform future interventions.
In September 2015, The American Journal of Tropical Medicine and Hygiene also published a supplement on the ICEMR program. The focus of the 2015 supplement was on the complex network of factors that affect malaria transmission, control and prevention. These include epidemiology, vector ecology, parasite diversity, insecticide and drug resistance, pathogenesis, diagnostic performance, as well as the impact of human migration, man-made ecological changes, climate, and vector behavior.
In October 2015, a Request for Applications was issued to recompete the ICEMR program for another 7 years in its renewed commitment to support malaria research and help eliminate the disease worldwide. In 2017, 11 awards were made that included 7 renewals and 4 new Centers. The awards continue the goal of supporting multidisciplinary malaria research to study the complex interactions between the human host, mosquito vector and the Plasmodium parasites that cause malaria.
The epidemiology of malaria is very dynamic and is rapidly changing in response modifications to the ecosystem caused by humans, and from public health interventions to control malaria. Multisite, multidisciplinary, integrated research is critical in high, low, and seasonal transmission settings to ascertain whether the research findings are applicable locally or can be generalized to the rest of the country. Such a broad-based, multidisciplinary approach is expected to integrate clinical and field research with laboratory, molecular and genomic methods to enhance the basic research underpinnings for effective malaria elimination and eradication. Data and findings generated by these Centers are expected to provide input critical to inform future research design and evaluation of new interventions and control strategies.
Rao M. The International Centers of Excellence for Malaria Research. The American Journal of Tropical Medicine and Hygiene; 2015 vol. 93 no. 3 Suppl 1-4.
Rao M. The International Centers of Excellence for Malaria Research. Acta Tropica 121(3):157. DOI: 10.1016/j.actatropica.2011.07.009 (2012).
Volkman SK et al. Application of genomics to field investigations of malaria by the international centers of excellence for malaria research. Acta Tropica 121(3):324-332. DOI: 10.1016.j.actatropica.2011.12.002 (2012).
Werndorfer WH. Global challenges of changing epidemiological patterns of malaria. Acta Tropica 121(3):158-165. DOI: 10.1016.j.actatropica.2011.06.014 (2012).