The antimalarial drug community needs to develop joint action plans to help funding agencies make the best use of the available resources in the coming years.
The challenge is to eliminate malaria in the next 50 years, rather than merely control it. This will require new tools, including drugs to replace those that have succumbed to the development of resistance.
In the current poor economic climate, donor fatigue and financial pressures mean that the current level of funding for research and development (R&D) may not be sustained. It is therefore important that those involved in antimalarial drug R&D come together to send clear messages to funders on R&D priorities, with details of what exactly is needed.
But the antimalarial drug R&D community is currently fragmented and unco-ordinated. This risks wasteful duplication of efforts in some areas, with others being neglected.
A coherent strategy
One ongoing attempt to develop a detailed, coherent strategy is the CRIMALDDI Consortium, a European Union-funded collaboration between Medicines for Malaria Venture (MMV), the WHO Special Programme for Research and Training in Tropical Diseases (TDR), and research groups in Europe and Africa.
The consortium has started to bring together malaria researchers and experts from related fields outside malaria to develop research priorities in a co-ordinated fashion. The external expertise enables lateral thinking and outside-the-box ideas to be considered.
Five key priority areas that could prevent rapid progress in antimalarial drug development in the next 5-10 years have been identified. The focus on enabling technologies (such as culture and screening systems) is one major barrier to rapid progress.
Malaria has undergone a resurgence of interest in the past 10-15 years, as the development of new tools, such as artemisinin-containing therapies (ACTs), has raised the possibility that the disease could be eradicated.
This has led to a huge increase in funding, including drug R&D support, and the setting up of various funding organisations such as MMV. It has also resulted in the creation of mechanisms such as the Affordable Medicines Facility - malaria (AMFm), which enables effective but expensive drugs to reach those most in need.
Malaria-related deaths are falling
The wider use of ACTs and vector control methods, along with better diagnosis of malaria, means that cases of malaria and resultant deaths are falling in many countries.
But malaria funding is likely to peak in 2011-12 for a variety of reasons, including the success of Roll Back Malaria's Global Malaria Action Plan, which is reducing the incidence of malaria infections, especially in Sub-Saharan Africa.
Given progress using current methods, such as bednets, antimalarial drugs and diagnostics, which show that many fevers previously treated as malaria are caused by other infections, it is inevitable that malaria will be seen as a declining problem needing less money, with less urgency to develop new drugs.
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