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New drugs, vaccine development key to malaria eradication
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VANCOUVER, British Columbia — Developing new medications and vaccines for malaria, as well as establishing treatment and prevention programs in endemic regions will play integral roles in eradicating malaria from the world, according to a panel of speakers at the 2010 Pediatric Academic Societies Annual Meeting, held here.
Optimizing currently available malaria treatments like chloroquine is very important, said Miriam K. Laufer, MD, MP, of the University of Maryland Medical Center.
“We’re using chloroquine as a tool to learn about combination of drugs to see if matching pharmacokinetic and pharmacodynamic profiles actually improves performance of the drug,” even in areas where performance is subpar, like sub-Saharan Africa, said Laufer.
She added that artemisinin-based combination therapy are replacing older, ineffective treatments, and as this happens, chloroquine susceptibility may also return in sub-Saharan Africa. She added that developing new classes of drugs and ways to implement them on a mass scale will remain key components of the malaria eradication research agenda.
Arlene Dent, MD, PhD,of Case Western Reserve University School of Medicine said that vaccine development for malaria presents special challenges.
“We’re looking at immunity that changes over time, so vaccines would be different for children and adults,” Dent said. “Moreover, parasites have a much larger genome than bacteria. They have multistage life cycles, and hosts, like mosquitoes, have coevolved with humans, all of which make vaccine development difficult.”
Research into several types of vaccines, including pre-erythrocytic, erythrocytic, blood stage and transmission-blocking vaccines, as well as the possibility of partial vaccines, is already in place, and these study results may indicate the best avenues to explore in this area.
Paradigm shifts, particularly in people’s notion of vaccination, will be needed, according to Chandy C. John, MD, of the University of Minnesota Amplatz Children’s Hospital in Minneapolis.
John emphasized the difference between vaccines that reduce infectivity and those that reduce disease. “This does require a paradigm shift, so that the focus is on reducing transmission and infectivity as opposed to disease in these regions,” said John.
John also explained that better diagnostic tests, improved ways of monitoring transmission and increased funding are all critical to the practical implementation of a successful malaria eradication campaign. — by Melissa Foster
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