Professor James Beeson, Deputy Director (People); Head, Malaria Immunity and Vaccines Group, and Dr Amaya Ortega Pajares, manager of the Cellular Responses to Disease and Vaccination lab, writes about the challenges and progress of malaria eradication for 360info.
Every minute, more than 400 people develop malaria, and around every minute, a person dies because of it.
Malaria is a threat to 40 per cent of the world’s population and despite ambitious targets set to eliminate it, progress in reducing the global burden has stalled for almost a decade.
We now need new strategies and tools to better prevent, treat, diagnose, and eliminate the infectious disease.
Malaria is transmitted to humans through the bite of infected Anopheles mosquitoes carrying a Plasmodium parasite (P. falciparum or P. vivax).
For more than 20 years, the widespread use of insecticide-treated bed nets and indoor spraying has been essential in the fight to reduce the spread of malaria.
However, changes in mosquito behaviours and increasing resistance of mosquitoes to insecticides, and parasites to antimalarial drugs, have reduced their effectiveness.
The World Health Organization’s recent recommendation of the first malaria vaccines (RTS,S /AS01 and R21/Matrix-M) was a major advance, but challenges remain.
The vaccine is intended for young children and has a relatively short duration of protection – requiring boosters after 12 to 18 months. Their efficacy is also affected by the genetic diversity of malaria parasites, and cannot provide coverage across all malaria strains.
For example, these vaccines are only effective against P. falciparum, which causes the bulk of malaria in Africa, but not P. vivax malaria, which is widely present across the Asia-Pacific region and parts of Africa and the Americas.
All infections must be effectively prevented, detected, and treated to eliminate malaria.
Many infections are not detected by routine surveillance or current diagnostic tests, they may also be asymptomatic and remain undiagnosed.
As a result, the transmission of malaria continues.
The epidemiology of malaria in the Asia-Pacific region, for example, is highly variable and diverse.
There are high rates of drug resistance, large reservoirs of undetected infections and diversity in the mosquito species that transmit malaria.
The widespread emergence of Plasmodium parasites, especially P. falciparum, resistant to antimalarial drugs, presents a considerable risk.
Developing new drugs to combat resistance, or optimising currently available drugs is hoped to provide better antimalarial therapy.
New tools that can better target the disease and prevent its transmission can ensure people’s well-being and survival from malaria.
Originally published under Creative Commons by 360info™.
