On the heels of this year’s World Malaria Day, which takes place annually on 25 April, the World Health Organization (WHO) is placing a special focus on prevention, a fundamental part of its Global Technical Strategy (GTS) that encompasses multiple approaches that collectively aim to reduce the incidence and mortality of malaria by at least 40% by 2030.
Sparked by the United Nations’ Millennium Development Goals, remarkable progress has been made towards malaria’s eradication since 2000. According to WHO, the incidence and mortality rates among at-risk populations have fallen by 21% and 29%, respectively, among all age groups, while among children aged five and younger, malaria death rates have declined by 35%. Nevertheless, in 2015 approximately 212 million new cases of malaria resulting in 429,000 deaths were reported, mainly in sub-Saharan Africa.
Moreover, there is evidence that drug resistance to artemisinin-based combination therapies (ACTs) – the standard of care for the treatment of malaria – is spreading in multiple geographic areas of South East Asia, intensifying the fundamental need to invest in the development of novel treatments.
Holistic approach to malaria treatment and prevention
GlobalData believes that, in order to achieve the GTS’s ambitious goal, a holistic approach to disease treatment and prevention, strengthened scientific and financial commitment, and further collaborations among non-profit organizations, governments, and pharmaceutical companies are necessary.
While novel treatments are currently in development to complement existing options, vector control is viewed by experts as the most important strategy for reducing disease transmission. Insecticide-treated mosquito nets (ITNs) and indoor residual spraying of insecticides (IRS) are the two forms of vector control most frequently leveraged in a variety of circumstances. Nevertheless, although the use of ITNs has increased substantially over the last decade—particularly in sub-Saharan Africa—in 2015, according to WHO, an estimated 47% of the population at risk did not sleep under a treated net. GlobalData expects that expanded access to ITNs would have a positive impact on malaria transmission.
In parallel, the use of IRS is another powerful way to rapidly reduce malaria transmission. According to WHO, despite the fact that 106 million people globally were protected by IRS in 2015, progress in the malaria fight is threatened by the emergence and spread of mosquito resistance to insecticides, to the point where 50 countries have reported resistance to two or more insecticide classes since 2010.
Although supplementary vector control methods, such as larval source management and personal protection measures, can be beneficial in specific settings and circumstances, WHO points out that preventive therapies for vulnerable groups – pregnant women, infants, and children aged five and younger – are fundamental tools just as important as innovative vaccines. Currently, more than 20 vaccine candidates are in various stages of development, among which GlaxoSmithKline’s RTS,S/AS01 is the most advanced.
Closing gaps in access to proven prevention tools is a critical strategy for achieving the ambitious malaria targets of the GTS. None of the approaches alone will be sufficient to win the fight against the mosquito-borne diseases; therefore, GlobalData believes that continuous efforts from public and private institutions, as well as robust investments in R&D of new tools, will be essential for eradicating malaria in the coming decades.