Unavoidable Science For Malaria Eradication

It is not an advocacy statement to highlight the importance of Research and Development in the extraordinary successes against malaria during the last decade. It is a fact. The reduction by 45% of the malaria mortality rates since 2000, the fell by almost 30% of the malaria incidence, and the more than three millions lives saved during that same period, would not have been even thinkable without tools we didn’t count with as soon as one decade earlier. Such tools are in great measure the results of the efforts of hundreds of scientists and their funders. If science and public health have always walked together, malaria is perhaps one of the clearest examples of this happy marriage.

Let’s take bed nets impregnated with long lasting insecticides as an example, as they are currently the most widespread preventive measure against malaria worldwide. These bed nets can reduce malaria episodes by more than 60%, protecting not only those that sleep under them, but the entire community. With an average cost of less than 1,5 euros per year of protection, this tool is one of the most cost-effective in the realm of public health. And they were only made available after years of rigorous scientific studies.

Just as with the nets, if a first generation of malaria vaccine is registered in 2014, as we all expect, it will be the outcome of top scientific research. This will be a great step, but it’s necessary to remind that it has taken nearly 30 years, the work of a multiplicity of actors and funders’ commitment to get to this point, and that in any case, work to develop a second generation of vaccines with greater efficacy and the capacity to interrupt transmission, will still be necessary after this great success.

There are many other examples. Drugs that are currently being used are the outcome of long lasting research and development, as a result of which Medicines for Malaria Venture (MMV) has to date the most extensive pipeline for new antimalarials ever. On their side, Rapid Diagnostic Tests, a simple, field ready and inexpensive tool that followed years of intensive scientific work, are now making possible to diagnose every suspected malaria case before treating it, therefore reducing the risk of resistances emerging among the malaria parasites.

Science is a long term endeavour, sometimes also perceived as an expensive one. But a job well done in this realm can really make the difference, saving not only millions of lives, but also millions of dollars. Besides the launch of a new tool, with no doubt the most spectacular outcome of science in global health, researchers also contribute in many other ways. Working hand by hand with national malaria control and elimination programmes, they can conceive solutions to emerging threats, or design innovative strategies to accelerate achievements at a lesser cost.

We need to recall the importance of supporting the generation of the knowledge we need to better fight malaria and eventually eradicating it. Previous experiences have clearly shown that neglecting science in global disease eradication efforts is a mistake we can not assume now that malaria eradication is again a foreseeable goal. Until we get to the final goal of zero malaria infections in the entire world, challenges will still emerge. Decisions will need to be based on the best available evidence, and innovation will be necessary until the very end.