Malaria eradication: achievable within a lifetime?

27 Jan 2011

Paul Chinnock

Source: PLoS Medicine (see original article)

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For many years the established view on malaria has been that, if the interventions already available can be delivered effectively where they are needed, control of the disease will be considerably improved. Elimination of malaria is also regarded as being achievable in certain endemic areas. Global eradication of the disease, on the other hand, has been considered an over-ambitious and unrealistic target.

But what if the fruits of research should be able to equip malaria control programmes with a range of newer and better tools? Will this bring eradication within our grasp?

Eradication and how it might be achieved formed an important part of the deliberations at the Malaria Forum convened by the Bill & Melinda Gates Foundation in October 2007. This led to the launch of a new initiative, the Malaria Eradication Research agenda (malERA), described as “a rigorous scientific consultative process to identify knowledge gaps and new tools that will be needed to eradicate malaria globally”. After two years work, with the participation of over 250 scientists, the agenda for research has been published in the form of a series of 12 rigorously peer-reviewed articles, available as a collection within the open-access journal PLoS Medicine.

A statement from malERA’s Leadership Council says, “…we hope that the publication of this research and development agenda encourages those involved in malaria research, especially scientists in malaria-endemic countries, to undertake new and challenging projects driven by the ultimate goal of global malaria eradication”.

The introductory article of the collection explains why eradication is an important and achievable goal, and the processes involved in drawing up the research agenda. In addition to the development of new interventions, the authors say, there is a need for supporting strategies which include building the knowledge base, operational research, training and the strengthening of the health systems that will deliver the tools once they have been developed. The article concludes that, “…it may be possible to fulfill the dream that malaria eradication can be achieved within the lifetime of young scientists just embarking on their careers, even in the most difficult areas where current tools/strategies have proven to be insufficient”.

Eight individual articles then deal with the priorities in each of the following areas:

basic science and enabling technologies
drugs
vaccines
vector control
diagnoses and diagnostics
health systems and operational research
monitoring, evaluation and surveillance
modelling.

Finally, three “reflective” articles consider the cross cutting issues in research and the lessons that can be learned from the viral disease eradication programmes and from the unsuccessful efforts made to eradicate malaria in the 1950s and 1960s.

Note: The malERA project maintains a website within the TropIKA.net domain. This can be accessed from the TropIKA.net home page or directly: http://malera.tropika.net/.