Research aiming to improve the delivery of proven, cost-effective interventions to reduce the burden of malaria must go hand-in-hand with studies to understand the biology underlying infection and develop new antimalarial tools, a report from the Wellcome Trust has concluded.
Released to mark World Malaria Day, 'Malaria 1990-2009' highlights the challenges and opportunities facing malaria research over the coming decades. The report also reviews the impact that funding from the Wellcome Trust, one of the world's leading funders of malaria research, has had on the field over the past two decades.
The Wellcome Trust's support of malaria research stretches back almost 75 years. Henry Foy, the Trust's first scientific employee, established the Wellcome Trust Malaria Research Laboratory in Thessaloniki, Greece, in 1938. The laboratory transferred to Nairobi, Kenya, in 1949, where it has evolved into one of the Trust's Major Overseas Programmes.
Over the 20 years from 1990 to 2009, the Wellcome Trust awarded £189 million to malaria-focused research. This accounted for 3 per cent of the Trust's total spend. In addition, it allocated £120 million to its Centres and Major Overseas Programmes, much of which facilitated malaria-related research.
The Trust also provided a further £8.8 million to malaria-related research at the Wellcome Trust Sanger Institute, which had a pivotal role in sequencing the genomes of the malaria parasite, the mosquito that transmits the parasite, and the human host.
Sir Mark Walport, Director of the Wellcome Trust, says: "There have been some very major advances in the fight against malaria over the past two decades, and I am proud of the key contributions that researchers funded by the Wellcome Trust have made to these developments. But malaria still takes many hundreds of thousands of lives each year, and this is unacceptable for a disease that can be controlled and prevented.
"Continuing research will remain vital because as we discover new drugs and insecticides, so the parasite and its vectors evolve to stay ahead. The emerging threat of drug resistance shows that the battle against these deadly parasites is as important as ever."
With the help of an Expert Group, chaired by Professor Dan Colley, Director of the Center for Tropical and Emerging Diseases, University of Georgia, USA, the report sets out several current challenges and priorities for the future of human malaria research. These include:
- Ensuring continued support for underpinning research into basic immune and biological mechanisms alongside clinical investigation, including ensuring that research explores parasites other than Plasmodium falciparum (the most deadly parasite, which is the focus of the majority of malaria research).
- Supporting malaria prevention and control through the delivery of antimalarial drugs, quality-assured diagnostic testing and novel vector control tools. In particular, the report stresses the need to ensure a pipeline of antimalarial drugs to combat growing resistance among the parasites.
- Continuing to build research capacity and research resources in priority areas, including supporting the development of malaria incidence and mortality surveillance tools and open databases for malaria research.
- Recognising the importance of international, multi-sector collaborations to tackle malaria and seeking out strategic partners to maximise the effectiveness of research funds and the impact of research findings on malaria.
Seven of the ten most highly cited malaria researchers in the world - including the top five - are funded by the Wellcome Trust. Heading the list is Professor Nick White, Chair of the Trust's Major Overseas Programme in South-east Asia, who has made a significant impact on understanding and treating malaria.
Professor White had an instrumental role in the development of artemisinin as the front line treatment for malaria and in demonstrating its effectiveness over existing treatments in both Asia and Africa. However, recent work published by Professor White and colleagues highlights the emergence of artemisinin-resistant malaria parasites, a worrying development that could signal the development of untreatable malaria.
"This timely report highlights the important challenges facing our field of research," says Professor White, a member of the Expert Group. "Malaria is a global problem that will only be solved by a global approach, crossing both geographical and disciplinary borders.
"Basic scientists and those developing new drugs, insecticides and vaccines must work alongside clinical researchers, health workers and public health officials to ensure that advances in our understanding of the biology of malaria infections are translated into improved prevention and treatment."