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Review
. 2013 Jun 6:12:187.
doi: 10.1186/1475-2875-12-187.

Designing the next generation of medicines for malaria control and eradication

Jeremy N Burrows  1 , Rob Hooft van Huijsduijnen, Jörg J Möhrle, Claude Oeuvray, Timothy N C Wells
Affiliations
Review

Designing the next generation of medicines for malaria control and eradication

Jeremy N Burrows et al. Malar J. .

Abstract

In the fight against malaria new medicines are an essential weapon. For the parts of the world where the current gold standard artemisinin combination therapies are active, significant improvements can still be made: for example combination medicines which allow for single dose regimens, cheaper, safer and more effective medicines, or improved stability under field conditions. For those parts of the world where the existing combinations show less than optimal activity, the priority is to have activity against emerging resistant strains, and other criteria take a secondary role. For new medicines to be optimal in malaria control they must also be able to reduce transmission and prevent relapse of dormant forms: additional constraints on a combination medicine. In the absence of a highly effective vaccine, new medicines are also needed to protect patient populations. In this paper, an outline definition of the ideal and minimally acceptable characteristics of the types of clinical candidate molecule which are needed (target candidate profiles) is suggested. In addition, the optimal and minimally acceptable characteristics of combination medicines are outlined (target product profiles). MMV presents now a suggested framework for combining the new candidates to produce the new medicines. Sustained investment over the next decade in discovery and development of new molecules is essential to enable the long-term delivery of the medicines needed to combat malaria.

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Figures

Figure 1
Figure 1
Example of cost breakdown of artemether lumefantrine ($1.50; R Bryant, personal communication for the API costs).
Figure 2
Figure 2
Breakdown of the ideal medicine into different target candidate profiles.
Figure 3
Figure 3
Diagram of the Plasmodium lifecycle and parasite load (z-axis,logarithmic) with stages targeted by the various TCPs.
Figure 4
Figure 4
Definition of the TPPs for elimination and eradication.
Figure 5
Figure 5
The positioning of new potential therapies, against a background of the competing challenges of the development of 'artemisinin resistance', and the advantages of a single dose cure.
See this image and copyright information in PMC

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