While global malaria incidence has decreased over the last two decades, progress is stalling. In 2017 there were 219 million cases, 435,000 deaths and an estimated 2.7 billion people vulnerable to infection – with over half in the Indo-Pacific region. According to recent research, malaria elimination in the Indo-Pacific by 2030 could avert 400,000 deaths, avert more than 120 million malaria cases and produce economic benefits of nearly USD90 billion.
WHO’s target is to reduce malaria incidence and deaths by at least 90 per cent by 2030. One key challenge is the emergence of malaria-causing parasites in South-East Asia that are resistant to the most effective treatments, artemisinin-based combination therapies (ACTs). The spread of drug-resistant malaria from South-East Asia presents a major threat globally, particularly to the Africa region that has the highest malaria burden.
Another challenge is that malaria is caused by different parasites, which vary by region, and can require different detection, treatment, and prevention strategies. For example, while the P. vivax parasite is not as deadly as P. falciparum, it causes the highest levels of morbidity and economic impact in the Indo-Pacific region. There is also increasing evidence of monkey to human transmission of P. knowlesii parasites, which presents additional challenges. The rapid innovation of new tools to combat the different forms of malaria, including more effective treatments, is required if we are to achieve the 2030 malaria elimination targets.
Australia seeks to address these issues by funding the research and development of more effective malaria treatments, through Product Development Partnerships (PDPs). PDPs bring together funding agencies, private industry and scientists to develop new drugs, diagnostics and other disease prevention and control technologies for use in poor-country settings where market incentives alone will not drive product development.
MMV is recognized as the leading product development partnership (PDP) in the field of antimalarial drug research and development. The Australian Government’s partnership with MMV began in 2013, with the PDP receiving $10 million. In 2017 an independent review found that DFAT’s investment in PDPs, through core funding, represented good value for money and that MMV’s innovations had made significant contributions to malaria elimination globally and in Australia’s region.
Although a small organisation, MMV has a broad reach internationally, both in the Asia Pacific region and elsewhere. Australia’s continued and visible support of MMV demonstrates the reach, the concern and the engagement of the country in combatting a disease of world-wide concern.
KEY INVESTMENT OUTCOMES
This is the first ACT to be granted positive scientific opinion under EMA Article 58 procedure, including the first approval for paediatric use (2015 – including approval for paediatric granules and a newly expanded label for adult tablets). The product is the first and only ACT approved for blood-stage treatment of P. falciparum and P. vivax, and will make a significant impact on the treatment of malaria in children.
- Improving clinical management of P. vivax malaria
Tafenoquine, a single-dose treatment developed by GSK and MMV for the radical cure of P. vivax malaria, was approved by the US Food and Drug Administration and the Australian Therapeutic Goods Administration in July and September 2018, under the names of Krintafel and Kozenis, respectively.