News Release

World Malaria Day: 2 years in the fast lane

Peer-Reviewed Publication

The Lancet_DELETED

The Lancet is publishing two Comments to coincide with this year's World Malaria Day (25 April). In the first of these Comments, Sir Richard Feachem and Allison Phillips, University of California San Francisco (UCSF) Global Health Group, discuss the rapid progress made in malaria control and elimination in the past two years — and their optimism for the future.

The strategy of Roll Back Malaria (a UN organisation) is in three parts – achieve low transmission and mortality in the 61 tropical countries with the highest malaria burden; progressive elimination from the endemic margins to gradually shrink the 'malaria map'; and research into vaccines, drugs and other interventions. The first part has seen a massive scale-up in antimalaria programmes, with Global Fund round 7 approving US$1 billion and round 8 pledging a staggering $2.9 billion. The US President's Malaria Initiative and The World Bank's Booster programme have scaled-up operations in the malaria heartland, and substantial malaria reductions have been achieved in, for example, Brazil, India, and Zambia. Private sector investment is increasing in places such as Angola, Nigeria and Ghana.

While part two (elimination) received little support two years ago, today 39 countries have set ambitious, yet attainable elimination strategies. Recent advice in two novel documents produced by the Malaria Elimination Group (part of UCSF Global Health Group) will assist all those involved in decision making for this second part. Regarding the third part, malaria research has continued to flourish. The Malaria Eradication Research Agenda (MalERA), has been recently launched and is developing a comprehensive research agenda to further malaria technologies.

In addition to this promising progress, a surge of NGO and civil-society activity in malaria has seen several organisations spring into existence, eg, Malaria No More, which has already raised over $37 million. Ray Chambers has been appointed as the UN Secretary-General's special envoy on malaria, and the US has followed the UK by setting up a non-party-political parliamentary group for malaria.

The authors say: "The challenge now is the implementation gap between political commitment, ambition, and availability of funds, and the capacity at ground level to do the work that needs to be done."

They conclude: "Overall, we have many reasons to be optimistic. Except for those countries that are politically dysfunctional or suffering major conflicts, the 61 malaria control countries in the heartland will make great progress in reducing death and sickness from malaria over the next 10 years. Meanwhile, many of the 39 malaria-elimination countries will successfully get rid of malaria, and the malaria gap will be substantially shrunk. Also, if the pace of malaria research continues, we can expect a first vaccine, important therapeutic advances, and further progress in the development of sensitive and specific point-of-treatment diagnostic tests. All this will move us forward towards a malaria-free world in the middle of the 21st century."

The second Comment discusses in detail the progress towards a vaccine, and is written by Dr Vasee Moorthy, John Radcliffe Hospital, Oxford, and University of Oxford, UK, and colleagues. The authors refer to two recent studies, by Bejon and Abdulla and their respective colleagues, that represent important steps toward a malaria vaccine. They say that these developments are 'driving commitments to research and development of a second-generation vaccine with a target efficacy of 80%, as outlined as a goal for 2025 in the strategic framework of the Malaria Vaccine Technology Roadmap', so long as funding and commitment are provided.

They add: "Areas of controversy remain in the design and analysis of malaria-vaccine trials, including whether primary attention should be focused on any delay in the first episode of malaria after vaccination, whether any second or subsequent episodes should be evaluated, or whether a better measure of effect might be in the proportion of children who have had no attack of malaria by some defined time after vaccination. These and related issues have been the subject of recent WHO consultations."

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Sir Richard Feachem and Allison Phillips, University of California San Francisco (UCSF) Global Health Group) +1 415-624-9444 / +1 415-490-7925 feachemr@globalhealth.ucsf.edu / phillipsaa@globalhealth.ucsf.edu

Dr Vasee Moorthy, John Radcliffe Hospital, Oxford, and University of Oxford, UK T) Wed/Thurs: +41 2279 14760; Fri onwards: +44 (0) 1869 331585 E) vasee.moorthy@gmail.com

For both Comments see: http://press.thelancet.com/malariacomments.pdf


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