University of Washington School of Public Health
Researchers help guide research agenda for malaria elimination and eradication
The World Health Organization has set ambitious goals for reducing the global burden of malaria. However, there is no easy path to achieving a malaria-free world and there is a real need for innovation.
University of Washington researchers took part in a collaboration that recently set forth a new research agenda to accelerate malaria elimination and, in the long term, global eradication.
Called the Malaria Eradication Research Agenda (malERA) Refresh, the project updated a 2011 agenda that identified key knowledge gaps and defined strategies to eliminate and eradicate malaria worldwide. The malERA Refresh resulted in seven research papers published together as a special collection in the journal PLOS One.
More than 180 malaria experts from around the world – organized into six panels – engaged in the collaborative process. Simon Hay, professor in the Department of Global Health, which bridges the UW Schools of Public Health and Medicine, was co-chair of the malERA Refresh panel on combination interventions and modeling. Panel Chair was Richard Steketee, science director for the Malaria Control and Elimination Program at PATH and affiliate professor in global health at the UW. The panel’s resulting paper focused on combinations of intervention strategies for malaria elimination and their evaluation using modeling approaches.
The paper acknowledged that progress been made since the original malERA recommendations, but that momentum has been met with significant challenges. According to the researchers, “experience with malaria intervention tools has grown, and the toolbox has expanded with new drugs, new insecticides, better diagnostics, and a first vaccine.” There has also been substantial improvement in transmission models that describe and predict the effects of ecologic changes and impact of specific interventions.
Researchers found an increasing need to combine interventions into “packages” that can be tailored to specific settings based on the characteristics of their transmission dynamics and epidemiology. The challenge, researchers say, is to identify the complementary components of each intervention package and establish the triggers and thresholds for their deployment throughout the elimination process.
The findings come from an extensive literature review of published and unpublished materials, as well as the deliberations of a 2015 malERA Refresh panel on combination interventions and modeling.
Overall, the malERA Refresh proposed a broad agenda for transdisciplinary solutions to critical challenges. It pointed to three areas in which innovation is critical.
- Iterative improvement in drugs and vector control to overcome resistance.
- Transformative improvement in tools and strategies to reduce, if not stop, the parasite’s capacity to transmit.
- Integrated approaches in which a robust elimination strategy responds to local variations in transmission dynamics, is tailored to the health and social system context, and draws strength from other sectors.
“To pursue the opportunities proposed here for accelerating elimination, a diverse landscape of funders is needed to prioritize research objectives according to their strategic plans and stakeholders’ needs,” the authors wrote in the collection’s main paper. The Malaria Eradication Scientific Alliance coordinated the malERA Refresh with funding from the Bill & Melinda Gates Foundation.