London School of Hygiene & Tropical Medicine Malaria Centre

Blandine Binachon at MIM 2018 | Current challenges facing malaria research

09 May 2018
MIM 2018 travel award winner

The 7th Multilateral Initiative on Malaria (MIM) Panafrican Conference was held from 15 to 20 April in Dakar, Senegal. It attracted more than 2,500 delegates. Around 350 oral presentations, 70 symposia, and 700 posters presentations were given. The delegates acknowledged “two decades of progress”, and discussed the “challenges and perspectives in ending malaria”, 21 years after the first MIM conference was held. Globally, the number of cases decreased and later on started to rise again, in particular in some countries. There are still substantive coverage gaps in many of the countries with a high malaria burden. 44 countries are close to the elimination stage. Many countries reached the pre elimination stage, and multiple tools and evidence are available and have to be used in combination, integrated in the health system, in order to achieve elimination.  

Three key current challenges were stressed: the resistance to pesticides (so far found in 60 countries); the emergence of the HRP2 deletion; and the drugs resistance (epicentre in the Greater Mekong sub region).

There is a particular need for innovations for getting the hard to reach populations and areas (for instance through community services and integrated community management), for the involvement of the private sector and the preventive therapies.

An update about some malaria vaccine candidates were given. The RTS,S/AS01 has been shown to provide partial protection against malaria among young children. The trials related to this candidate are still going on as part of the Malaria Vaccine Implementation Programme coordinated by the WHO. The live parasite Plasmodium falciparum sporozoite (PfSPZ)-based vaccine candidates have been evaluated in more than 30 clinical trials so far. Efforts continue to develop a range of whole parasite vaccines and to combine subunit vaccines targeting diverse stages of the parasite’s life-cycle. It is likely that some vaccine candidates will reach licensure by the mid-2020s. Meanwhile, antimalarials are used for prevention in endemic populations, following various strategies adapted to the epidemiological contexts, including seasonal malaria preventions, mass drug administration, and intermittent preventive treatment in infants, children and pregnant women.

Research findings showed that some genetic mutations are likely to be driving the drug artemisinin resistance.

Recent data on pyrethroid insecticide resistance in African malaria vectors suggested that it is to some extent responsible for malaria persistence, decreasing the performance of vector control tools such as Insectide Treated Nets. Research currently conducted will allow a better understanding of the impact of pyrethroid resistance on personal and community protection; and will allow an effective management of insecticide resistance.

The LSHTM was well represented at the 7th MIM with several oral communications, symposia and poster presentations, along with the Malaria Centre booth and an alumni reception held at the conference venue during the week.