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Friday, April 25, 2014
NIH World Malaria Day statement
Statement by B.F. (Lee) Hall, M.D., Ph.D., and Anthony S. Fauci, M.D..
On World Malaria Day, it is encouraging to note that enhanced global efforts to control and eliminate malaria have saved an estimated 3.3 million lives since 2000.
However, the mosquito-borne disease continues to sicken and kill far too many people each year, most of them children. In 2012, roughly 207 million cases of malaria occurred worldwide resulting in 627,000 deaths, according to the World Health Organization (WHO). In 2013, 97 countries had ongoing malaria transmission, placing 3.4 billion people at risk for the disease. And in a globally connected world, even people living in the United States can be at risk. In 2011, nearly 2,000 people in this country were diagnosed with malaria — the highest number since 1971. Virtually all of those cases occurred in U.S. residents or citizens who had travelled abroad.
The WHO World Malaria Day theme is “Invest in the Future. Defeat Malaria.” The National Institute of Allergy and Infectious Diseases (NIAID), part of the National Institutes of Health (NIH), affirms its continued commitment to supporting and applying innovative research approaches to find new treatments and tools for addressing this infectious disease. For example, through the establishment of the International Centers of Excellence for Malaria Research in 2010, we have worked to strengthen research capacity in the countries most affected by malaria. The 10 research centers, which operate 50 sites in 20 countries, have established dynamic programs to understand the epidemiology of malaria as it changes over time due to the implementation of malaria control and elimination programs. The research centers have also created capacity for clinical trials of novel antimalarial interventions.
NIAID is supporting 21 anti-malaria treatment candidates in various stages of preclinical and clinical testing. Last year, NIH-supported researchers from 16 international institutions identified a new class of antimalarial compounds that target multiple stages of the malaria parasite’s lifecycle. Additionally, NIAID-supported investigators also identified the protein essential to all stages of the malaria parasite’s lifecycle. When tested in infected mice and nonhuman primates, a newly identified class of anti-malaria drug compounds inhibited the protein and stopped the development of the parasites. Further evaluation of these compounds is continuing. In addition, several investigational malaria treatments are undergoing clinical testing. For example, the novel anti-malaria drug DSM265 is being evaluated in a Phase I clinical trial through collaboration between NIH scientists and the nonprofit Medicines for Malaria Venture.
NIAID researchers are also targeting the malaria-spreading mosquitoes. For example, NIAID-funded researchers infected Anopheles stephensi mosquitoes with Wolbachia bacteria, which prevented malaria-causing parasites from developing in the mosquitoes. Moreover, the researchers demonstrated that the bacterial infection can be transferred between generations of mosquitoes, raising hope that the strategy could be employed in future malaria control strategies. NIAID-supported scientists have also demonstrated how mosquitoes are attracted to humans and identified compounds that, if developed further, could potentially mask human scent and lure the insects into traps.
Given that parasite resistance to the first-line malaria drug arteminisin has emerged in at least four countries, NIAID is simultaneously working to find new malaria drugs and develop methods for detecting resistance in an effort to slow its spread. In 2013, NIAID scientists working with French and Cambodian investigators developed two tests that can determine in three days whether the malaria parasites in a particular patient are resistant or susceptible to arteminisin. The tests offer significant advantages over current tests in terms of cost and time to diagnosis, and may be used for future studies designed to better understand the molecular basis of resistance and to screen new malaria drugs. NIAID investigators are also working with local investigators in Southeast Asia and Africa to study resistance in an effort to tailor treatment to a given region. An international team of researchers, including NIAID scientists, identified a genetic mutation that made some malaria-causing Plasmodium falciparum parasites in Cambodia resistant to arteminisin. Further study is under way to understand how the mutation causes resistance, whether it is present in other regions of the world, and how it might be addressed.
Insecticide resistance among mosquitoes — now present in more than 60 countries — is also a growing concern for malaria control efforts. To assist on this front, NIAID-funded investigators have identified several compounds that repel mosquitoes and which could eventually be developed into alternatives to the commonly used repellent DEET.
A vaccine to prevent malaria is a primary goal of the NIAID malaria research agenda. NIAID is supporting research involving 11 investigational malaria vaccines in various stages of clinical development and evaluation. One investigational vaccine, PfSPZ, which uses weakened malaria parasites delivered intravenously, was found to be safe and protective when tested in a small initial clinical trial in 57 adults last year. Additional follow up studies of the candidate vaccine are being planned.
NIAID also conducts and supports research designed to help those most vulnerable to malaria, including children and pregnant women. For example, NIAID investigators and other researchers recently described the protective immune response that occurs among children in Mali who are repeatedly exposed to malaria-infected mosquitoes based on where they live. The findings may help researchers develop future interventions to prevent or mitigate the effects of malaria infection.
World Malaria Day reminds us that while scientists and the public health community have made significant strides in the fight to end malaria, considerable challenges remain. We are committed to working with the global community to address these challenges to find the necessary treatment and prevention tools to control, eliminate, and eventually eradicate malaria.
Lee Hall, M.D., Ph.D., is chief of the Parasitology and International Programs Branch in the NIAID Division of Microbiology and Infectious Diseases. Anthony S. Fauci, M.D., is the director of the National Institute of Allergy and Infectious Diseases.
NIAID conducts and supports research — at NIH, throughout the United States, and worldwide — to study the causes of infectious and immune-mediated diseases, and to develop better means of preventing, diagnosing and treating these illnesses. News releases, fact sheets and other NIAID-related materials are available on the NIAID Web site at http://www.niaid.nih.gov.
About the National Institutes of Health (NIH): NIH, the nation's medical research agency, includes 27 Institutes and Centers and is a component of the U.S. Department of Health and Human Services. NIH is the primary federal agency conducting and supporting basic, clinical, and translational medical research, and is investigating the causes, treatments, and cures for both common and rare diseases. For more information about NIH and its programs, visit www.nih.gov.
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