Professor Sir Richard Feachem
Policy Advisor, Malaria No More UK

In the past handful of years, campaigners, researchers, doctors and healthcare professionals have united to take the fight to malaria. After years of trying to control it, the focus is now on elimination. The Global Health Group at the University of California, San Francisco is a leading light in this ramping-up the battle against malaria and its Director, Professor Sir Richard Feachem, believes one need only to look at rapid recent progress as well as an encouraging drugs pipeline to be confident.

“Public health initiatives have got rid of malaria in half of the 200 countries it was once present in,” he says. “So it’s now found in 100 countries which are either controlling it, to go from high incidence to medium to low, or eliminating it where they are at low rates and are seeking to rid themselves of the disease altogether.” Such progress has been possible, he reveals, by two separate approaches in countries controlling and eliminating.

To combat the parasite we now have rapid diagnostic tests as well as ACT combination drugs which cure people in three days

“In controlling countries, you can protect against the mosquito with insecticide-impregnated nets and indoor residual spraying as well as larvicides, where practical,” he says. “Then to combat the parasite, we now have rapid diagnostic test as well as ACT combination drugs which cure people within three days.

“In elimination countries, it’s then all about focusing on geographic ‘hot spots’ where the disease flares up as well as ‘hot pops’ or populations at risk, particularly people who are out at night, such as policemen.”

Encouraging pipeline
The good news is that although there is a potentially worrying sign that in ‘Greater Mekong’ area, parasites are starting to show signs of resistance to ACT pills, there are new treatments on the way. “Resistance is worry but it’s being tackled and we have new tools in the pipeline,” says Feachem. “We have a vaccine available in about a year, maybe two. It’s effective in around a third of cases but subsequent vaccines will improve on this. We also have new drugs that are doing well in phase one, two and three trials and so we should have additional treatments available from 2020 onwards.”

With such an encouraging pipeline of vaccines and treatments, Feachem believes that is not overly optimistic to predict malaria can be eliminated in all countries and not just the half who have managed the feat so far.