From David Beckham’s mosquito “attack” to Tom Daley’s trip to Malawi, describing diagnostics as “plastic miracles”, malaria has certainly been making headlines in the build up to World Malaria Day this year.
Still, progress is stalling in the global fight against this disease. As WHO put it, “without urgent action, the major gains in the fight against malaria are under threat.” On World Malaria Day today, we join the community in celebrating the progress that has been made – while also calling on all stakeholders to keep up the momentum if we are to achieve the ambitious global targets for malaria elimination.
Fighting malaria is complicated because there are different species of Plasmodium that can infect humans, and infections can be asymptomatic. While P. falciparum is the most deadly variant, P. vivax accounts for 65% of malaria cases in Asia and South America – and can also lead to severe disease and death – yet existing diagnostic tests do not perform sufficiently well for P. vivax. Current conventional rapid diagnostic tests (RDTs) do not detect sub-clinical infections, so they remain untreated and contribute to the continued transmission of the disease. Additionally, some populations are particularly vulnerable to the disease, such as pregnant women – in whom around 70% of malaria infections during pregnancy are missed by RDTs or microscopy.
To help address these challenges, our malaria & fever programme has just received a significant boost in the form of a 5-year grant from Australia’s landmark Health Security Initiative, to accelerate the development and adoption of better diagnostic tools and testing protocols for malaria, and also TB. In malaria, the grant will support the development of diagnostics for low-density and subclinical infections, as well as critical clinical studies that will provide data to support the accelerated registration of new products for P. vivax detection and elimination. These will be complemented by policy and implementation initiatives to ensure access and uptake.
We are already working with manufacturers to develop more sensitive tests, and several promising, innovative technologies are being trialed. One is a P. falciparum rapid test that is ten times more sensitive than current RDTs when tested in the laboratory, created with Standard Diagnostics, supported by the Bill & Melinda Gates Foundation and PATH. We are excited to be partnering with the Papua New Guinea (PNG) Institute of Medical Research and the Burnet Institute to trial this new diagnostic in PNG.
Over the last decade of our collaboration with WHO on malaria RDT product and lot testing, more than 200 different malaria RDT products have been evaluated and performance data has been published to help procurers to select the best available tests. Lot testing ensures that individual lots meet required quality standards before being used with patients. As a result of the product testing, the proportion of malaria tests in the public sector that do not meet current WHO quality standards has reduced from over 76% to less than 4% – a result that ensures that the malaria tests available in endemic countries are doing their job, thereby saving lives and slowing transmission.
In collaboration with Eiken, we developed a commercially available P. falciparum LAMP diagnostic kit; at the World Malaria Congress in Melbourne in July we will present first results of the evaluation of a P. vivax version of the kit that is currently in development.
This year the world is getting “ready to beat malaria” – to us that means redoubling our commitment to continue working with our partners to advance new and exciting developments, while taking care to protect the progress that has been made.
Read more about FIND’s malaria projects.