Strategies aimed solely at malaria control will require significant sustained funding and will remain vulnerable to insecticide and drug resistance. The imperative, therefore, is to eradicate plasmodium parasites from the human population. This can only be achieved through (i) radical cure of malaria infection at the individual level and (ii) targeting the human transmission reservoir at the population level. Drugs, administered synchronously along with effective transmission prevention tools, will be crucial to any eradication effort.
The Medicines for Malaria Venture (MMV) is a not-for-profit virtual drug R&D organization established in 1999 to catalyze the discovery, development and facilitate delivery of new malaria medicines. Since then, MMV and its partners have launched 4 drugs and currently have 7 projects in clinical development. A current area of focus for MMV is the development of a single encounter radical cure and prophylaxis (SERCaP) for malaria elimination and eradication. The profile of the ideal SERCaP includes:
1. For P. falciparum – elimination of asexual blood-stage forms and the long-lived asymptomatic mature gametocytes. The elimination of gametocytes will reduce transmission.2. For P. vivax – elimination of asexual blood-stage forms and the dormant hypnozoites in the liver.3. Providing some protection against reinfection for the patient.4. Ability to be taken in one encounter with a health worker.
Significant progress has been made in identifying molecules that could contribute to a SERCaP. This has been achieved through pre-competitive collaboration between pharmaceutical companies and academic groups, coordinated by MMV and including the use of common assays to screen molecules for activity against various stages of the parasite lifecycle. Promising lead compounds have been optimized and have entered clinical testing. Pharmacokinetic and induced human infection model studies conducted in collaboration with Australian centers of excellence have been instrumental in expediting these compounds through early phase clinical development.