Neglected Diseases
Malaria is a parasitic disease transmitted through the bite of an infected female Anopheles mosquito.
The two most common types of malaria are caused by Plasmodium falciparum and Plasmodium vivax. Left untreated, malaria can cause severe illness and death. Children and pregnant women are among the most vulnerable, with more than 70% of all malaria deaths occurring in children under five years of age.
There remains a clear need for a more efficacious vaccine and vaccines that can protect against P. vivax and placental malaria, and/or block transmission. New drugs are needed in response to emerging resistance and to meet the needs of key populations, as well as for chemoprotection, and – ideally – to meet the goal of a single-dose treatment. In addition to small molecule drugs, monoclonal antibodies (mAbs) are being investigated, though large-scale administration is not yet suited to low-resource settings. There is an urgent need to develop new rapid diagnostic tests in response to emerging pfhrp2/3 gene deletion in malaria parasites, as well as more sensitive diagnostics to identify non-falciparum species, distinguish malaria from other febrile illnesses, detect asymptomatic cases, and diagnose G6PD enzyme deficiency. Next-generation vector control products are needed in response to emerging pyrethroid resistance, including genetic approaches to reduce mosquito populations or block parasite transmission, and endectocides for malaria transmission control.
R21/Matrix-M – developed by the University of Oxford and Serum Institute of India – became the second malaria vaccine to be prequalified by the WHO in December 2023. Ghana, Nigeria and Burkina Faso were the first countries to approve the vaccine. Mitsui Chemicals Agro’s VECTRON T500, an indoor residual spray with a novel mode of action effective against resistant mosquitoes, received WHO prequalification in March 2023. BioNTech initiated a Phase I trial in late 2022 for BNT165b1, a circumsporozoite protein targeting mRNA vaccine, the first candidate emerging from their multi-antigen vaccine programme. In 2023, Brazil became the first malaria-endemic country to approve single-dose tafenoquine for children with relapsing P. vivax infections.