Video interview with malaria experts:

We already have a number of effective drugs, why do we still need to develop new ones?

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Keeping one step ahead: developing the next generation of drugs

The current generation of antimalarial drugs, artemisinin-based combination therapies or ACTs, are highly effective at curing malaria, even the most lethal falciparum form which is increasingly resistant to other drugs. This is because ACTs use a combination of drugs to combat the parasite, one of which is artemisinin a potent antimalarial extracted from a Chinese herb – Artemisia Annua.

There is, however, no room for complacency. The wily Plasmodium falciparum malaria parasite has a tendency to become resistant to medicines. This means that, even as we are using ACTs to cure millions of people worldwide and working to deliver ACTs to many millions more, we do not know how long these medicines will remain effective. We will always need something new in the medicine cabinet.

If and when the parasite becomes resistant to ACTs, a new antimalarial will be needed with a different way of working. To prepare for this eventuality, MMV’s focus has been on building a world-class and diverse portfolio of antimalarial projects, so that new compounds are already well ahead in the R&D process and are closer to emerging from the pipeline as an effective drug.

From control to eradication: another reason for R&D

There is another pressing reason for the discovery and development of new drugs. The global agenda has recently changed from just controlling malaria to eventually eradicating it: wiping the parasite off the face of the planet. This ambitious vision has driven a change in MMV’s approach. We will continue to develop drugs to treat uncomplicated falciparum malaria as outlined above, but we will also develop new drugs to different ends.

One new goal, driven by the eradication agenda, is to research and develop drugs which block transmission of malaria between people, and so help protect those at risk but not yet infected. Malaria is transmitted by the blood-feeding Anopheles mosquito, which acts as a ‘flying syringe’ to carry parasite from one person to another. MMV is developing drugs which will kill these sexual parasite stages and block transmission.

Another area of innovation is medicines to kill the parasite in the second most common form of malaria, Plasmodium vivax, when the parasite hides, dormant, in a person’s liver. Without an effective ‘radical cure’ for these dormant parasites – and the two current drugs are very far from ideal – patients can be cured of the blood parasites but suffer repeated malaria relapses months after the initial infection when the dormant liver forms reawaken. MMV has a new drug, Tafenoquine, in advanced clinical development to meet this need.