April 25, 2013 | The Editors

No more malaria

World Malaria Day 2013Malaria’s impact on individuals and society is so profound that it’s not enough to pursue a partial solution. At PATH, we’re using multiple lines of attack to fight the disease. We are developing and implementing strategies with national and global partners to create expanding malaria-free zones (and eventually eliminate the disease); bringing together public- and private-sector partners to accelerate the development of malaria vaccines; and working to create a steady, affordable, and high-quality supply of drugs for malaria treatment.

As we mark World Malaria Day, it’s a good time to take a look at the suite of tools we’re using to fight malaria, and to take stock of our progress over the past year.

Control, treat, prevent, advocate

Despite the more than 200 million cases of malaria people suffer every year, in the last decade the world has made incredible progress in controlling the disease. In some places, reductions in deaths and illness have been so great that the potential exists to create malaria-free zones.

We’re working with national malaria control programs to target the malaria parasite village by village. Our approach combines gathering better data through rapid reporting of malaria cases, testing and treating entire communities, and improving surveillance systems to track remaining infections. In Zambia, we helped train more than 1,100 workers in this approach in 2012. Now, Ethiopia and Senegal are laying the groundwork to strive for eventual malaria elimination.

Diagnostic technologies are crucial in this effort. Our teams are working to ensure universal access to existing diagnostic testing in countries with high malarial burden. And we’re generating a comprehensive evidence base for product development and strategic program operations to determine the most efficient use of existing and new diagnostic technologies in support of malaria case management for malaria infection detection in areas where the disease is near elimination.

Watch this video for an overview of our combined approach to fighting malaria.

We’re also working to reduce illness and death caused by malaria in pregnancy by increasing intermittent preventive treatment in pregnancy with antimalarial drugs and insecticide-treated bednets.

New source for treatment

Just two weeks ago, we announced the successful launch of another key component in the elimination of malaria: industrial-scale production of the drug derivative at the center of the most effective treatment. Until now, supplies of artemisinin, derived from the sweet wormwood plant, have depended upon a notoriously volatile crop. That’s meant drastic fluctuations in price and availability.

To address this challenge, PATH and our partners, through our new drug development program, figured out a way to create a new, stable supply of artemisinin. Earlier this month, our private-sector partner began large-scale production of semisynthetic artemisinin. Production will bolster the botanical supply of artemisinin, expanding access to treatment.

A relentless search for vaccine

A vaccine would give us another tool to use against the disease. Last November, PATH’s Malaria Vaccine Initiative (MVI) and partner GlaxoSmithKline Vaccines announced the latest results from the ongoing late-stage trial of the most advanced malaria vaccine candidate, RTS,S.

The results show that RTS,S reduces episodes of malaria by one-third in infants who are 6 to 12 weeks old when they receive the first of three injections, compared to infants who receive a different vaccine that doesn’t target malaria—about 270 malaria cases averted per 1,000 infants vaccinated with RTS,S. In 2011, we reported results in the older age group in the study; children aged 5 to 17 months when they got their first shot. In this group, the number of malaria episodes was cut in half for those receiving RTS,S versus those who got another vaccine—about 750 cases averted for every 1,000 toddlers.

As MVI’s director Dr. David Kaslow commented at the time, “developing a vaccine against a human parasite is a really, really hard thing to do.” It’s never been done before, David explained, in part because we’re fighting a wily parasite that moves between humans and mosquitos. But we are making progress, and what we learn at each step has implications not only for malaria, but for defense against other parasitic diseases.

Expanding on success

Making a difference against malaria requires many things—strong partnerships, willingness to innovate, and dedication to advocating for support as we reach toward eventual elimination of this ancient and complex disease. Strong support from stakeholders the world over has helped get us to this optimistic point, and we at PATH are determined to continue forcefully advocating for an end to the disease.

On this World Malaria Day, that remains an audacious goal. But next World Malaria Day, we’ll be closer to elimination, and the year after that, nearer still.

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