World Malaria Day on 25 April
Urgent call for research to meet drug resistance challenge
Since 2007 an increase in malaria control and prevention has saved many lives.
World Malaria Day on 25 April 2011 aims to acknowledge this achievement and to
enhance awareness of the urgent tasks yet to be done. A staggering number of
881.000 people still die from malaria every year, mostly in sub-Saharan Africa
(91%), most of them (85%) children under 5 years of age. The growing risk of
resistance against effective antimalarial drugs is one of the threats to the
international ambition to eliminate malaria deaths by 2015. The European and
Developing Countries Clinical Trials Partnership (EDCTP) fully supports the
global call to action. Its current investment in fighting malaria stands at €
68.73 million for clinical research.
EDCTP contributes to the fight against malaria by funding research into
development of more new drugs and drug combinations, clinical development of
novel vaccine candidates and enhanced clinical trials capacity in Africa. EDCTP
projects include studies of both artemisinin based combination therapies (ACTs)
and non ACTs, aiming at establishing therapies that are safe and highly
effective in real world situations. Ongoing studies involve special patient
groups such as infants, malnourished children, HIV/AIDS co-infected individuals
and pregnant mothers. Additionally, EDCTP supports clinical research and
development of candidate malaria vaccines that include MVA METRAP, AdCh63
ME-TRAP and GMZ2.
Among EDCTP-funded malaria projects are the following clinical trials:
As part of studies involving pregnancy associated malaria, EDCTP funds a
project that aims to optimise the existing dose and regimen of intermittent
preventive treatment with sulfadoxine-pyrimethamine. This treatment is to
prevent malaria in pregnant women in areas where there is a high coverage of
insecticide treated nets and where malaria transmission is highly seasonal. The
study compares intermittent preventive treatment (IPTp) with intermittent
screening and treatment of malaria (IST).
In Zambia, Malawi and Mozambique EDCTP funds a phase III/IV clinical trial to
identify safe and efficacious ACTs that can be administered to HIV-positive
patients who receive antiretroviral medication and in very young or
malnourished children. Concurrently, the study aims to establish the
appropriate age-based dosing where weight-based dosing is not feasible. This
study started recruiting patients in August 2010.
EDCTP is also funding a phase IIIb/IV clinical study is to assess the safety
and efficacy of repeated administration of four repeated ACTs over a two-year
period in children and adult patients with acute uncomplicated malaria. This
project is being carried out by the West African Network for Clinical Trials of
Anti Malarial drugs (WANECAM). The study is expected to generate important
safety and efficacy data that will contribute to the registration of the new
generation ACT’s: pyronaridine-artesunate and dihydroartemisinin-piperaquine.
EDCTP-funded research into the efficacy of a novel antimalaria agent,
fosmidomycin, has started in 2010. This phase II/III clinical trial aims to
determine the optimal therapeutic regime for administering fosmidomycin
together with clindamycin to children suffering from acute uncomplicated
malaria. This project is taking place in Mozambique, Benin, Gabon and Tanzania.
All these projects reflect EDCTP strategy of integrating regulatory quality
research with investment in clinical capacity development and expanding
research networks in sub-Saharan Africa. For more information on EDCTP malaria
projects, see the EDCTP malaria factsheet http://bit.ly/fgeITo.