World Malaria Day 2019: New Innovations, Same Targets: Public Health Watch

On the eve of World Malaria Day 2019, there is, after several years of relative silence, some good news to report in the battle against the mosquito-borne disease.

As reported by the BBC on April 23, World Health Organization (WHO) officials have announced plans for a pilot study in Malawi of a new vaccine—called RTS,S—to significantly reduce the disease in children. The vaccine candidate contains the QS-21 Stimulon from Agenus, a potent adjuvant. Earlier, phase 3 studies demonstrated that the vaccine is up to 40% effective at protecting infants who receive it against the disease, according to the WHO.

The announcement comes at a key time in the fight against malaria globally, as well as in Africa. As experts from around the world gather at the Johns Hopkins Malaria Research Institute (JHMRI) in Baltimore, Maryland, for a scientific symposium entitled “Malaria Elimination in Africa” for the 13^th World Malaria Day on April 25, the challenges surrounding the disease remain significant.

After much progress was made in the late 2000s and early 2010s, innovations in the prevention and treatment of malaria have largely slowed since 2015. According to the WHO’s most recent World Malaria report, released in 2018, estimates of deaths related to the disease remained essentially unchanged from 2016 to 2017, at nearly 450,000 annually. More than 90% of the world’s malaria deaths occur in sub-Saharan Africa, and most occur in children 5 years of age and younger.

“We’ve seen over the past 2 decades enormous progress in reducing the burden of disease, particularly in sub-Saharan Africa,” Bill Moss, MD, professor in the Infectious Disease Epidemiology Division at Johns Hopkins Bloomberg School of Public Health, told Contagion®. “Still, efforts have stalled over the past couple of years. So I think this is a critical moment in the fight against malaria. Are we going to see progress? Or, will we lose ground because of factors such as insecticide resistance within the vector or drug-resistance in the parasite [that carries malaria]?”

The JHMRI has been funded by Bloomberg Philanthropies since 2001 to create a state-of-the-art research facility for mounting a broad program of basic-science research to treat and control malaria, develop a vaccine, and find new drug targets to prevent and cure this deadly disease. The World Malaria Day symposium will focus on the challenges to ending the malaria epidemic in Africa, including insecticide resistance, and new tools and strategies for the elimination of the disease in the region, including the use of genetic modification.

In addition to Moss, who will deliver a lecture entitled “Malaria Elimination in Southern Zambia: Studies of the Southern and Central Africa ICEMR,” speakers at the JHMRI event will include experts from across the globe speaking on everything from asymptomatic reservoirs of malaria and novel approaches for malaria control to updates on the WHO’s E-2020 initiative to eliminate malaria in 21 member countries by 2020.

“The title of the symposium is intentionally provocative and ambitious,” Moss told Contagion®. “We’re a long way from eliminating malaria in Africa. However, we’re going to hear different perspectives on the fight against malaria, from organizations like the WHO and PATH, and we’re going to hear from a country, Zambia, that has an ambitious program to eliminate malaria. We’re also going to hear about current challenges, including insecticide resistance and the asymptomatic reservoir, older individuals who can harbor malaria parasites without being sick. We’re also going to hear about issues related to human movement and cross-border transmission. And, finally, we’re going to hopefully end on a positive note and discuss some new elimination tools, [including] lab techniques to monitor transmission, such as genotyping and serology, and vector-control strategies, such as genetic modification.”

For those who unable to attend the meeting in person, it will be webcast online; however, advance registration is required.