"If successful, this new antimalarial combination will have an enormous effect on malaria elimination"

2021
Dr Rella Manego

Tackling resistance in uncomplicated malaria

In response to emerging partial artemisinin resistance, next-generation combinations are being investigated to eventually replace existing therapies. One frontrunner combination is ganaplacide–lumefantrine, currently being investigated in Phase II clinical trials. 

Dr Rella Manego discusses the burden of malaria in Gabon and the Phase IIb study investigating ganaplacide–lumefantrine in children as young as six months old with uncomplicated malaria.

1. What is the burden of malaria in Gabon and what impact does the disease have on individuals, communities, and the country as a whole?

Gabon has a high burden of malaria, with 50% of the population infected at any one time. Malaria results in a high fever and a high mortality rate in vulnerable populations, including children under five years of age. This high prevalence has an impact on individuals and communities as malaria keeps people out of work, leading to an economic impact on the country as a whole.

2. The ganaplacide–lumefantrine Phase IIb study is being conducted in four African countries. What is exciting about this combination and study?

The Phase IIb study is being conducted in Gabon, Mali, Burkina Faso and the Republic of Guinea. Ganaplacide–lumefantrine has shown fast-acting activity against multiple stages of the malaria parasite life cycle and effectively reduces malaria transmission. It is exciting because this study is investigating a new, once-daily formulation of lumefantrine in combination with ganaplacide in children as young as six months old with uncomplicated malaria.

3. Why is the trial needed in children between the ages of 6 to 12 months?

Children are at highest risk of dying from malaria, however, there can be problems with current formulations of antimalarials when administered to children. To treat this high-risk population, we need new child-friendly formulations.

4. Why is it important to have another treatment for uncomplicated malaria?

It is important to have new drugs to treat uncomplicated malaria in the event of emerging parasite drug resistance. A single-exposure radical cure would be the ideal antimalarial in this setting. It is also important that any new treatment for uncomplicated malaria is affordable.

5. What benefits do you see from the study being managed through a partnership between a pharmaceutical company (Novartis) and a not-for-profit organization (MMV)?

There are mutual benefits to having the study managed through this partnership. At every stage, the experience can be shared between partners, particularly regarding manufacture and distribution, which benefits study management as well as the malaria patients themselves.

As a new combination, it will help tackle emerging resistance and, with its short regimen, it will improve compliance. If successful, this new antimalarial combination will have an enormous effect on malaria elimination.