Caused by poverty but also a cause of poverty, malaria – a preventable and treatable disease – is one of the world's deadliest diseases with 429.000 deaths in 2015 and 212 million new cases worldwide according to the World Health Organization (WHO). Roughly every two minutes a child dies from malaria. Under the Sustainable Development Goals (SDG) 1 and 3, the European Union (EU) is committed to working with the global community to reduce poverty and to ensure healthy lives for all.
In the last decade, a global coordinated effort played an important role in achieving significant progress in malaria control as a result of using insecticide-treated bed nets and effective medicines. According to the World Malaria Report 2016, between 2010 and 2015, the rate of Malaria death rates dropped by 29% and by 21% for new malaria cases. These improvements are threatened by the development of resistance to medicines by the parasite and to insecticides by the mosquito vector, as well as the poor quality of the health systems in many affected countries.
In May 2015, the World Health Assembly approved the WHO Global Technical Strategy for Malaria 2016–2030, providing a comprehensive technical guidance to countries and development partners for the next 15 years, emphasizing the importance of scaling up malaria responses and moving towards elimination. It also highlights the urgent need to increase investments across all interventions – including preventive measures, diagnostic testing, treatment and disease surveillance – as well as in harnessing innovation and expanding research.
The European Union's contribution to Malaria research
Under the FP7 and Horizon 2020 framework programmes, a total of 86 malaria research projects have been funded with a support of EUR 160 million. These projects focused on diagnosis, vaccine development, vector control, treatment, as well as basic and operational research, research infrastructures and training
The European & Developing Countries Clinical Trials Partnership (EDCTP) was launched in 2003 by 16 European countries and the European Commission to support clinical trials and capacity building to fight HIV/AIDS, malaria and tuberculosis in Africa. The first EDCTP programme (2003-2013) supported 254 projects with EUR 383 million, involving 190 African and 70 European research institutions and where 49% of the trials were led by African researchers. The EU's commitment has an increased budget of EUR 1.3 billion for the second programme (2014-2024). Under the second European and Developing Countries Clinical Trials Partnership programme, 6 projects in malaria have been selected with an EU contribution of EUR 9.5 million. The new project IMPROVE is specifically testing intermittent preventive treatment for malaria in high-resistant areas of Africa. The project has a grant budget of EUR 7.4 million and is coordinated by the Liverpool School of Tropical Medicine, UK.
The MCD project, led by a small Dutch company, In2Care has developed a very simple way of protecting people from malaria by installing plastic tubes in exterior house walls. The Eave Tubes are fitted with a net with a special coating and an insecticide. The net prevents the mosquitos from entering the house, the coating enhances the distribution of insecticide and the insecticide kills the mosquitoes. The project reports a reduction of 85-90% of mosquitoes in the homes. The project has leveraged other grants – a one year grant from the Dutch Organisation of Scientific research to study and unravel the binding forces and particle interactions of the electrostatic coating deployed in Eave Tubes; and a 5-year grant from the Bill & Melinda Gates Foundation to further develop the Eave Tube technology in West Africa where there is a high insecticide resistance.
DIAGMAL project has developed a molecular diagnosis test for malaria in resource limited situations. This test is done directly on blood and it does not require sample processing. It has an excellent sensitivity and specificity, allowing for Plasmodium species discrimination, and a simple and cheap read-out system. This has been tested in clinical trials in Kenya and Vietnam. This diagnostic platform for malaria can have a key role in the global elimination effort as it allows detection of low density infections. It is currently under negotiation for commercialization.
COSMIC aims to improve maternal and infant health while combatting malaria infections in pregnant women. It encourages Community Health Workers (CHWs) to use the rapid diagnostic tests (RDTs) and to detect malaria infections much earlier allowing more effective treatment. The health workers can also raise awareness of the importance of the preventive treatment. It also stimulates pregnant women to attend antenatal care centres more frequently, it increases CHWs work satisfaction and they are seen by the communities as important contributors to the health system. Policy makers in the project countries are aware about the impact of the study which has been carried out in Benin, Burkina Faso and The Gambia, and are studying further implementation. The outcomes of this research will help refine the WHO recommendations on tackling pregnancy associated malaria.
Two new projects addressing vaccine development have just been selected with the very challenging approach of targeting the several stages of the malaria parasite: OPTIMALVAX project tackling the Plasmodium falciparum, the most predominant infection in Africa; and MULTIVIVAX project, the Plasmodium vivax, the parasite that mainly affects Southeast Asia and the American populations.