Entomologists study mosquitos at the National Center for Research and Training on Malaria in Burkina Faso in West Africa. Photo: Olympia De Maismont/AFP/Getty Images
As world leaders, advocates and others meet in France this week to discuss the Global Fund's replenishment for its programs targeting tuberculosis, HIV and malaria, a group of international experts say malaria can be completely eradicated within this generation — via more funding, new data tools, political will and promising drugs.
Why it matters: The fight against malaria has seen great overall progress since 2000, with death rates dropping 60%, global incidences falling 36% and more than half of all countries reporting being free of malaria. However, it still kills a child every 2 minutes and the fight has plateaued or lost ground in some parts of the world.
The backdrop: The 4 main parasite species that need to be targeted evolve quickly and can become drug resistant.
- Richard Feachem, director at UCSF's Institute for Global Health Sciences and global health professor at both UCSF and UC Berkeley, told Axios, "One of the challenges we have in malaria is the evolutionary arms race — the parasite has become resistant to the drugs we use, and the mosquito has become resistant to the insecticides."
- The World Health Organization issued a 3-year study on malaria in August that said malaria eradication is key to saving lives and addressing economic woes but declined to give a timeframe for eradication.
The other side: 41 malariologists, biomedical scientists, economists and health policy experts from around the world published a report in The Lancet, examining various factors they say show the world is at a "tipping point" in the war against malaria — but they are confident it can be eradicated "within this generation."
- "The evidence clearly shows complete eradication of malaria for humankind is possible by 2050 or sooner," says Feachem, who also is the Lancet Commission co-chair.
- Malaria eradication would be "of historic importance ... it's probably killed more human beings than any other disease," Feachem adds.
4 main steps are needed, per Feachem:
- Strengthening management systems to implement more data-driven programs and community/private sector participation.
- Developing new tools and technologies including drug development.
- Increasing funding by an additional $2 billion per year (to a total of $6.3 billion/year) that also incorporates more domestic spending.
- Encouraging stronger leadership and new accountability mechanisms.
What they're saying: Axios was also invited to a roundtable discussion by the Center for Strategic and International Studies to listen to the Lancet Commission discuss ideas to facilitate the timeline.
"We have the option to move to real-time data capture. ... If we can change from a paper-based system that takes months [to process] and often doesn't give feedback ... it will change behavior."— Kenneth Staley, U.S. global malaria coordinator, President's Malaria Initiative
"How do you operationalize countries that are high burden but [have] low standards?"— Stephen Morrison, SVP and director, CSIS Global Health Policy Center
"Already governments are putting more money into malaria ... That requires a whole-of-government approach to looking at financing, from increasing tax revenues to allocating more money to health. ... [But] there must be political will, where the leaders [can] make these tough choices."— Muhammad Pate, global director of health, nutrition and population, World Bank
"We have great tools today. They are not perfect, but if we could just maximize the ones we have today ... we could save millions of lives."— Robert Newman, director of AMP Health, The Aspen Institute
Meanwhile, research is ongoing for possible targets in gene-editing or drug development, like two studies that developed a tool and a cell atlas to help map out the genes of some of the parasites, and looking at a possible TCMDC-135051 inhibitor.
- WHO says a "landmark vaccine" pilot has been launched in Kenya, Ghana and Malawi, although the Mosquirix (RTS,S) vaccine made by GlaxoSmithKline is said to provide limited protection.
What we're watching: How the Global Fund, which is one of the main malaria funders, does in its current drive to get $14 billion in funding for malaria, TB and HIV when it's facing some donor fatigue.