Malaria Eradication Hardware

The most pressing biological challenges to eradication include the development of drug and insecticide resistance, insufficiently sensitive parasite detection methods, limited effectiveness of standard vector control interventions in areas with intense malaria transmission and where outdoor biting is common, and the spillover of zoonotic simian malaria into humans. Fortunately, tools with strong potential to overcome these challenges are either already in the malaria community’s arsenal or are rolling out, and the research and development pipeline for new technologies has never been stronger.

Molecular methods for diagnosis and surveillance, novel drugs and insecticides, and a malaria vaccine have all become available in recent years. The research and development pipeline is expected to yield additional new drugs and insecticides, innovative vector control strategies, and more sensitive and precise diagnostics over the coming decade. In the longer term, gene drive technologies have potential to radically reduce transmission in the most challenging settings.

Research and development targets for malaria eradication that are most promising and impactful are shown in Figure 5B. New tools will be particularly valuable if they improve surveillance, have long durations of efficacy, do not require difficult or protracted compliance from individuals, counter-drug and insecticide resistance, and are able to reduce malaria in high transmission settings.

Figure 5B ([in full report]) - Projected future effect of global trends and enhanced malaria control on malaria endemicity

This framework shows innovations according to the probability of successful development (vertical axis), the timeline of availability (horizontal axis), and their relative effect on accelerating eradication efforts (size of colored circle). Investment opportunities should be prioritized on the basis of the relative size of the colored circle and its probability of successful development. Product availability is based on prospective registration dates. ACT=artemisinin-based combination therapy. RDT=rapid diagnostic test. u-RDT=ultrasensitive rapid diagnostic test. *These include a Plasmodium falciparum RDT that does not rely on the detection of pfhrp2 and pfhrp3, and a P vivax RDT.