New medicines to help counter drug resistance and tools like gene drive technologies to curb parasite transmission are among the innovations needed to rid the world of malaria, according to a new research agenda published as a special collection in PLOS Medicine on November 30. The papers were authored by over 180 scientists, malaria program leaders, and policy makers — including Harvard T.H. Chan School of Public Health researchers — who collaborated for over a year to update a research agenda for eradicating the disease. According to the World Health Organization (WHO), there are 91 countries and territories with ongoing malaria transmission.
The ‘malERA Refresh’ (malaria eradication research agenda) was coordinated by the Malaria Eradication Scientific Alliance (MESA) with headquarters at the Barcelona Institute for Global Health (ISGlobal). The collection complements WHO’s Global Technical Strategy for Malaria (GTS) and the Roll Back Malaria Action and Investment to defeat Malaria (AIM).
“The value of malERA Refresh is that it focuses on problems that need to be solved, not only the technologies that could be developed,” MESA chair Dr. Regina Rabinovich, ExxonMobil Malaria Scholar in Residence at Harvard University in the department of immunology and infectious diseases at Harvard Chan School, said in a press release. “Transforming the mindset from implementation to problem solving is an essential task for the next generation of scientists and program implementers.”
Dr. Dyann Wirth, Richard Pearson Strong Professor of Infectious Diseases and chair, department of immunology and infectious diseases at Harvard Chan School, and Dr. Rabinovich were part of the group that led the initiative. The leadership group also included Dr. Pedro Alonso of the WHO Global Malaria Programme and Dr. Marcel Tanner of Swiss Tropical and Public Health Institute.
“We’re approaching an exciting time in the field of malaria,” Dr. Wirth said. “In the area of basic science and enabling technologies, we’re now able to combine the research knowledge gained over the past 5 – 10 years with powerful new tools, such as CRISPR-based genome editing and other versatile high-throughput applications of functional genomics. The malERA Refresh recommendations set forth an ambitious, but achievable scientific research agenda to both target and exploit key biological features in the parasite and mosquito vector to eradicate the disease.”
Among the research and development gains made since 2011 highlighted in the introductory paper were large-scale testing of the first approved vaccine (RTS,S), non-pyrethroid insecticides in the pipeline, new genetic technologies to block parasite transmission by mosquitoes, and identification of markers of drug resistant parasites. However, the authors noted, significant challenges also have arisen, including increased insecticide and drug resistance and knowledge gaps, particularly when working in low disease transmission settings.