World Malaria Report calls for new ways to eliminate malaria

TDR news item
29 November 2017

This year’s annual World Malaria Report issued by the World Health Organization (WHO) has documented increasing numbers of countries moving toward elimination of the disease, while also noting the need for new approaches to re-ignite stalled progress in many other areas.

The WHO European Region remains malaria-free. A number of African countries have achieved impressive improvements in diagnostic testing and surveillance. However, many of the countries with the highest burdens have reported significant increases in malaria cases.

The results of this report signal a clear need for greater investment in malaria control – particularly at the domestic level. Funding for the global malaria response has plateaued since 2010, reaching US$ 2.7 billion in 2016 (less than half of the 2020 funding target).

Dr Abdisalan Noor, the author of the report and head of surveillance for the WHO Global Malaria Programme, called for better and smarter ways to invest available resources. “Closing gaps in coverage of the tools that we know work is absolutely critical, as is continued investment in the research and development of new tools.”

TDR efforts in malaria

TDR works closely with WHO and many other partners in a number of key areas to build research capacity and identify new approaches. Below is a list of some activities that are either focused on malaria specifically, or in combination with other vector-borne diseases.

Access and Delivery Partnership: TDR is part of a broad, multi-partner effort to strengthen capacity in low- and middle-income countries that improves access to and delivery of new health technologies. These technologies include drugs, diagnostic tools and vaccines that are relevant for the prevention, treatment or cure of tuberculosis, malaria and neglected tropical diseases.

Innovative training builds capacity for stronger drug safety monitoring: A new health worker training model in Nigeria, adapted from a global research and capacity-building initiative, has been shown to increase reporting of adverse drug reactions (ADRs) in a country treating the largest population of people living with HIV/AIDS, tuberculosis (TB) and malaria.

Rectal artesunate suppositories launched for severe malaria in young children: Artesunate Rectocaps/Rectal Artesunate Suppositories (RAS), a life-saving, pre-referral intervention for the management of severe malaria in young children, are now available. Initially developed by TDR, the treatment manufactured by Cipla in coordination with the Medicines for Malaria Venture was recently added to the Global Fund Expert Review Panel’s list of quality-assured medicines, while the process of the World Health Organization (WHO) prequalification of this medicine moves through its final stages. This authorization makes it the first quality-assured RAS product.

New global vector control response at World Health Assembly: TDR has been working with the Global Malaria Programme and the Department of Control of Neglected Tropical Diseases to tackle multiple vectors and diseases with more integrated approaches. This includes not only the health sector but environment, urban planning, and education as well. Delegates at this year’s World Health Assembly agreed on the Global Vector Control Response (GVCR) 2017-2030 to prevent epidemics of vector-borne diseases in all countries, reduce the incidence of these diseases by at least 60% and cut mortality rates by at least 75% by 2030.

Malaria Data Access Committee launched: TDR has convened an independent Data Access Committee to support the WorldWide Antimalarial Resistance Network (WWARN) data contributors in making decisions on access to malaria datasets. This is part of TDR’s commitment to expanding access to data and increasing collaborations.

Safety of drugs in pregnancy: A broad collaboration is underway with the World Health Organization and external partners to assess the consequences to mothers and their newly born children of drug exposure during pregnancy. The collaboration establishes the safety of any drug exposure, such as antiretrovirals for HIV, malaria medicines, and treatment for schistosomiasis, visceral leishmaniasis and other parasitic diseases. TDR is developing a central registry for the collection and collation of data from pregnancy registries to enable the early detection of any potential signal of teratogenicity and provide evidence to inform treatment guidelines for pregnant patients.

Implementation research training: TDR provides a continuum of training materials on implementation research, including an online toolkit that has been named one of the top ten community engagement tools. Implementation research is the systematic approach to understanding and addressing barriers to effective and quality implementation of health interventions, strategies and policies, particularly important in the end stage of malaria elimination. It is demand-driven, with research questions framed on the basis of needs identified by relevant stakeholders/implementers working together in the health system.

SORT IT operational research and training: Public health programmes in low- and middle-income countries, working with WHO, identify their challenges or bottlenecks on specific issues. TDR supports national public health workers to be trained to use their country’s own data to conduct research that can lead to local health system improvements. Participants work on topics such as multidrug-resistant tuberculosis, malaria, neglected tropical diseases, maternal and child health, HIV and non-communicable diseases.

Special collection of articles on neglected infectious diseases in Myanmar: The journal Infectious Diseases of Poverty is issuing a special collection of operational research articles seeking evidence-based solutions for improving the performance of national programmes for neglected infectious diseases in Myanmar. Five papers, focused on malaria and tuberculosis (TB) control, have been published to date.

Clinical research and development fellowships: This one-year programme is designed for scientists from developing countries to work with pharmaceutical and research institute partners to learn how to lead clinical drug and vaccine trials. The ultimate goal is to reduce research bottlenecks as more new products enter the development pipeline, and develop strong research capability in low- and-middle income countries with infectious diseases.

For more information, please contact Piero Olliaro.