Malaria

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Status Brief
History/Origins:

Developmental Milestones/Developments to Date:

Current Assessment/State of the Field:

Problems/Challenges:

Proposals:

2009

Brown, Matthew Hay, “Hopkins and Catholic Group to Shield World Against Malaria,” Baltimore Sun, p. 1, Nov. 6, 2009.

  1. “two Baltimore institutions tapped for a five-year; $100 million project to help combat the mosquito borne disease.  the school will work with Catholic Relief Services.”
  2. “Malaria kills up to 3 million people a year, the great majority of them in Africa, and most of them children under 5 years old.  The disease can cause brain damage or cognitive and learning deficiencies in children, according to the Global Program on malaria, and can account for up to 40 percent of a country’s health expenditures.”
  3. “Particularly labor-intensive are plans to design individualized programs on a country-by-country basis, for greatest efficiency and impact.”

Malaria, Developing Countries, Africa, Public Health

2011

Chan, Dr Margaret, “Combat Drug Resistance: No Action Today Means No Cure Tomorrow,” World Health Organization, April 6, 2011 http://www.who.int/mediacentre/news/statements/2011/whd_20110407/en/   Last Checked 9/5/2011

  1. “In the absence of urgent corrective and protective actions, the world is heading towards a post-antibiotic era, in which many common infections will no longer have a cure and, once again, kill unabated.”
  2. “The development of resistance is a natural biological process that will occur, sooner or later, with every drug.”
  3. “We have assumed that miracle cures will last forever, with older drugs eventually failing only to be replaced by newer, better and more powerful ones.”
  4. “For some diseases, like malaria, our options are very limited as we have only a single class of effective drugs- artemisinin-based combination therapies- with which to treat more than 200 million falciparum cases each year.”
  5. “While TB deaths are declining, in just the past year nearly half a million people developed multidrug-resistant TB, and a third of them died as a result.”
  6. “Irrational and inappropriate use of antimicrobials is by far the biggest driver of drug resistance.”
  7. “In several parts of the world, more than 50% in tonnage of all antimicrobial production is used in food-producing animals.”

Drug Resistance, WHO, Malaria, Tuberculosis

 

White, Nicholas, “A Vaccine for Malaria,” The New England Journal of Medicine, October 18, 2011   http://www.nejm.org/doi/full/10.1056/NEJMe1111777 Last Checked 10/19/2011

  1. “It is becoming increasingly clear that we really do have the first effective vaccine against a parasitic disease in humans.”
  2. “If there are no unforeseen disasters, the RTS, S/AS01 Plasmodium falciparum malaria vaccine should become available in just over 3 years.”
  3. “The World Health Organization (WHO) has already taken the unusual step of indicating that it could recommend this first malaria vaccine for use in some African countries as early as 2015, depending on the full phase 3 trial results that will become available in 2014.”
  4. “The vaccine has been developed by a public–private partnership between GlaxoSmithKline and the Program for Appropriate Technology in Health (PATH) Malaria Vaccine Initiative, supported by the Bill and Melinda Gates Foundation, primarily for use in infants and young children in sub-Saharan Africa.”
  5. “In this issue of the Journal, the RTS,S Clinical Trials Partnership provides an interim report of a large, multicenter phase 3 trial of this vaccine.”
  6. “A total of 15,460 children in two age categories — 6 to 12 weeks and 5 to 17 months — were enrolled.”
  7. “The report describes vaccine efficacy against P. falciparum malaria in the first 6000 of 8923 children in the older age category, together with an evaluation of the first 250 cases of severe malaria from the two age groups.”
  8. “The very low rate of death from malaria in this large trial (only 10 deaths directly attributed to malaria) testifies to the benefits of providing early diagnosis and effective anti-malarial treatment.”
  9. “An assessment of an 18-month booster dose will not be available until 2014.”

Vaccination, Malaria, Drug Resistance, Africa, WHO

2014

Gamo, Francisco-Javier. “Antimalarial Drug Resistance: New Treatment Options for Plasmodium.” Drug Discovery Today: Technologies, Volume 11. 81. March 2014.

  1. ”Millions of lives are threatened by the continued development of resistance in the malaria parasite which is overcoming the effectiveness of current antimalarial treatments.” – page 81
  2. ”Malaria is an infectious disease caused by protozoa of the genus plasmodium and is transmitted by infected female anopheles mosquitoes.” – page 81
  3. ”More than 219 million cases and around 660,000 deaths are the alarming data provided by the World Health Organization in the last World Malaria Report.” – page 81
  4. ”Current antimalarial therapy is built upon only a few different chemotypes: atovaquone, sulfadioxine-pyrimethamine combination, chloroquine, primaquine, mefloquine, and artemisinin.” – page 81
  5. ”The main strategies to advance the development of new treatments for malaria have been based on (a) target based screening, through the assessment and validation of new antimicrobial targets as well as seeking for new chemical diversity to interfere with already validated targets or processes, and (b) whole cell screening using large chemical libraries” – page 84
  6. ”It may be necessary to combine different chemical entities with a variety of therapeutic profiles as part of a single treatment to assure effectiveness against intra-erythrocytic stages, thus relieving clinical symptoms, to block parasite transmission, and to reduce the potential for the emergence of resistance.” – page 87
  7. ”New antimalarial treatments should display novel mechanisms of action with efficacy against already existing multi-drug resistant strains.” – page 87

Drug Resistance, Public Health, WHO, Chemical, Malaria

 

Sibley, Carol “Understanding Drug Resistance in Malaria Parasites: Basic Science for Public Health.” Molecular & Biochemical Parasitology. 107. July 2014.

  1. ”Drug resistance is genetic, and the treatment of most parasites has depended heavily on effective drugs, so the evolution and spread of resistance to those drugs is unavoidable.” – page 107
  2. ”Plasmodium falciparum, a malaria parasite, is a useful prototype to use because it is a widespread and potentially fatal infection to humans that has been studied intensively for more than 100 years.” – page 107
  3. ”Malaria symptoms have been treated with drugs for hundreds and likely thousands of years, beginning with qinghausu in ancient China, and quinine in the 17th century, but the first widely used manufactured antimalarial was chloroquine. It was widely deployed after the Second World War and has been used to treat hundreds of millions of malaria patients.” – page 108
  4. ”In the public health arena, antimalarial treatment efficacy is measured according to guidelines regularly updated by the World Health Organization.” – page 108
  5. ”It had been established that patients infected with parasites that carried the ‘resistant’ pfcrt 76T allele were more likely to fail chloroquine treatment than those whose parasites carried a ‘sensitive’ K76 allele.” – page 109
  6. ”In 1993, the Ministry of Health withdrew chloroquine as the recommended malaria treatment and substituted pyrimethamine-sulfadioxine, SP.” – page 109
  7. ”In 2008, Malawi, a small country in south central Africa, changed its recommended antimalarial to the artemisinin combination therapy (ACT), artemether-lumefantrine.” – page 109
  8. ”Adoption of ACTs as the recommended antimalarial treatment was strongly recommended by the WHO beginning in 2006.” – page 111
  9. ”As their use increased, ACTs made a major contribution to the solid decline in malaria disease and mortality during the current decade and they remain clinically effective in most regions of the world.” – page 111

Drug Resistance, Public Health, WHO, Military, China, Developing Countries, Africa, Malaria