Malaria eradication and elimination: views on how to translate a vision into reality

Abstract

Although global efforts in the past decade have halved the number of deaths due to malaria, there are still an estimated 219 million cases of malaria a year, causing more than half a million deaths. In this forum article, we asked experts working in malaria research and control to discuss the ways in which malaria might eventually be eradicated. Their collective views highlight the challenges and opportunities, and explain how multi-factorial and integrated processes could eventually make malaria eradication a reality.

Fig. 1

Marcel Tanner is Director emeritus of the Swiss Tropical & Public Health Institute and Professor (chair) of Epidemiology and Medical Parasitology, University of Basel. His research ranges from basic research in cell biology and immunology on malaria, schistosomiasis, trypanosomiasis and filariasis to epidemiological and public health research. Research, teaching and health planning are based on long term work in Africa and Asia

Fig. 2

Brian Greenwood is an infectious disease physician who worked and lived in West Africa for 30 years before joining the London School of Hygiene & Tropical Medicine where he is now a professor of tropical medicine. His main research interests are malaria and epidemic meningitis. He has conducted research on many aspects of malaria including its epidemiology, pathogenesis, treatment and prevention and is currently contributing to the evaluation of the leading candidate malaria vaccine RTS,S/AS01

Fig. 3

Christopher JM Whitty is Professor of Public and International Health at the London School of Hygiene & Tropical Medicine (LSHTM), and Chief Scientific Advisor and Director of Research at the UK Department for International Development (DFID). He was previously director of the LSHTM Malaria Center and of the ACT Consortium

Fig. 4

Evelyn Korkor Ansah is a Deputy Director of the Research and Development Division of the Ghana Health Service, an adjunct lecturer at the School of Public Health, University of Ghana and the Chair of the Institutional Review Board of the Dodowa Health Research Center. She is currently one of the two vice-chairs of the Technical Review Panel of the Global Fund and a Steering Committee Member of the ACT Consortium, London School of Hygiene & Tropical Medicine. She has more than 15 years of experience in managing District Health Services including extensive operational research on malaria diagnosis

Fig. 5

Ric Price is an infectious disease physician, Professor of Tropical Medicine at the University of Oxford, UK and Professor of Global Health at the Menzies School of Health Research, in Darwin, Australia. His research programme focuses on the diagnosis, consequences and containment of multidrug resistant malaria. He is head of the clinical module of the Worldwide Antimalarial Resistance Network (WWARN) and co-Chairs the Vivax Working Group of the Asia Pacific Malaria Elimination Network (APMEN)

Fig. 6

History of chloroquine-resistant P. falciparum malaria. Reproduced with permission from Packard, New England Journal of Medicine 2014; 371:397-399 [28]. Data are from the WorldWide Antimalarial Resistance Network

Fig. 7

Arjen M Dondorp is a Professor of Tropical Medicine at the University of Oxford, U.K., and a visiting Professor of Clinical Tropical Medicine at Mahidol University in Bangkok, Thailand. He is the Deputy Director and Head of Malaria Research at the Mahidol Oxford Tropical Medicine Research Unit in Bangkok, Thailand. He chairs the Regional Steering Committee for the Global Fund Regional Artemisinin Initiative and chairs the Technical Expert Group on Antimalarial Drug Resistance and Containment for the World Health Organization. His main research interests include antimalarial drug resistance, the pathophysiology and treatment of severe malaria, and care for critically ill patients in resource limited settings

Fig. 8

Lorenz von Seidlein has worked for 20 years on malaria and other issues in global health. He worked in The Gambia on the first evaluations of ACTs in sub-Saharan Africa, and has managed several large vaccination projects. He is currently coordinating a major effort to eliminate malaria from areas with artemisinin resistance with the Mahidol Oxford Research unit In Bangkok, Thailand

Fig. 9

J. Kevin Baird is Professor of Malariology at the Centre for Tropical Medicine, Nuffield Department of Medicine, University of Oxford. He has been Head of Unit at the Eijkman-Oxford Clinical Research Unit within the Eijkman Institute for Molecular Biology in Jakarta, Indonesia since 2007. Kevin serves on several advisory groups and committees for the World Health Organization for the prevention, treatment, and control of Plasmodium vivax malaria. He and his Indonesian colleagues conduct laboratory- and hospital-based research and clinical trials of interventions against acute and endemic vivax malaria, especially those aimed at attacking the hypnozoite reservoir of this parasite

Fig. 10

James Beeson is Head of the Centre for Biomedical Research at the Burnet Institute, Australia, and leads a research group focused on human immunity and vaccines against malaria, including clinical and population studies of malaria in Africa, Asia and Papua New Guinea. James trained in clinical medicine and public health, and completed a PhD on malaria in pregnancy at the University of Melbourne, Australia and the Walter and Eliza Hall Institute, Australia

Fig. 11

Freya Fowkes is Head of the Malaria and Infectious Disease Epidemiology group at the Burnet Institute, Australia. She trained in parasitology at the University of Glasgow, UK, and then obtained an MSc in epidemiology from the London School of Hygiene and Tropical Medicine, UK, before completing her doctorate in infectious disease epidemiology at the University of Oxford, UK. Freya is involved primarily in examining the epidemiology of malaria, in particular drug resistance, immunology, host genetics and susceptibility to malaria and associated morbidities

Fig. 12

Janet Hemingway is Director of Liverpool School of Tropical Medicine and Professor of Insect Molecular Biology. She initially trained as a geneticist, and has 30 years of experience working on the biochemistry and molecular biology of specific enzyme systems associated with xenobiotic resistance. In recognition of her contributions to Tropical Medicine she is an Honorary Life Fellow of the Royal College of Physicians, the Royal Entomological Society and the American Academy of Microbiology, an elected Fellow of The Royal Society, an overseas Fellow of the National Academy of Sciences, USA, a Commander of the British Empire (CBE), and an elected Fellow of the Academy of Medical Sciences

Fig. 13

Kevin Marsh is a senior advisor at the African Academy of Sciences and professor of tropical medicine at the University of Oxford. Kevin has a particular interest in developing and strengthening research capacity and scientific leadership in Africa and is currently supporting the development of a new platform for the acceleration of science in Africa through the African Academy of Sciences. He is chair of the WHO Malaria Policy Advisory Committee and is a member of a number of international advisory committees relating to malaria and to global health research. Image reproduced with permission from the Wellcome Trust

Fig. 14

Faith Osier is a Wellcome Trust Clinical Research Fellow and an MRC/DfID African Research Leader based at the KEMRI-CGMR-C in Kilifi, Kenya where she leads a group of African scientists. She is a Visiting Professor of Immunology at the University of Oxford and the Secretary General of the Federation of African Immunological Societies (FAIS)