Despite progress to fight malaria, millions of people continue to suffer every year. We’re helping by researching medicines and vaccines, supporting community prevention and health worker training and strengthening access to medicines.
Malaria is one of the world’s oldest diseases, with evidence of the mosquito-borne illness found in tissues from Ancient Egyptian mummies. But despite its long history and our understanding of its biology, malaria remains one of the world’s deadliest diseases.
Millions of people continue to suffer from malaria every year. Although there has been significant progress in scaling up access to bed nets, anti-malarials and other preventative measures, malaria still claims the lives of over 400,000 people in the world’s poorest countries every year. Around 90% of estimated deaths from malaria happen in sub-Saharan Africa – many of them are young children. To address this, the World Health Organization (WHO) has set a target to cut malaria cases and deaths by at least 90% by 2020.
What is malaria?
In 1897, scientist Ronald Ross made the connection between mosquitoes and malaria, discovering that the female Anopheles mosquito carries the malaria-causing Plasmodium parasite. The enemy is tiny, but it packs a punch. There are five different types of Plasmodium parasite – falciparum is most prevalent in sub-Saharan Africa, while vivax is most common in South and South East Asia, Latin America and the horn of Africa.
For all types of malaria, people are infected with the parasite through a mosquito bite. If you are unlucky enough to get an infection, you can expect fever, shivering and vomiting but if left untreated, can lead to anaemia, seizure, coma and even death. Allan Pamba, a doctor who is now Vice President for GSK in East Africa, remembers suffering from malaria when he grew up in Kenya: “I fell prey to malaria about once a year – feeling sick as a dog with a profoundly painful headache and high temperature.”
"I survived this horrible disease to see my fifth birthday. Sadly, many other children were not so fortunate."
Fighting malaria on all fronts
Our legacy in fighting malaria stretches back more than a century, beginning with Sir Henry Wellcome pioneering organized research of tropical diseases. Today, we continue to tackle malaria on all fronts – from researching medicine and vaccines to supporting community prevention and health worker training; and supplying anti-malarial medicines.
The fight begins in our labs. At our research and development facility at Tres Cantos in Spain, we have around 50 scientists working on malaria. These scientists, who come from inside and outside GSK, are carrying out innovative research focused on the very earliest stages of discovery. Our researchers get to see almost all of the medicines that are in development across the global malaria community because our technology gives researchers a chance to determine their compound’s potential to kill the malaria parasite quickly.
We also share our own compounds and data with scientists to help advance the pace of progress in malaria research. More than 2 million compounds in our chemical library have been screened for activity against the malaria parasite. Data on 13,500 compounds was published and shared as part of a ‘malaria box’ sent to 160 research groups around the world.
The search for the ‘sleeping’ parasite
Of the five different types of Plasmodium parasite, Plasmodium vivax is particularly sinister. By managing to find a place to ‘sleep’ within the liver, this parasite evades our immune system, enabling it to resurface weeks or months after the first mosquito bite, leading to repeated episodes of illness. These relapses can affect people of all ages when they least expect it leading to significant public health and economic impact.
But finding ways to overcome the malaria parasite’s defence mechanisms is not an easy task. The P. vivax parasite is a complex organism and no one has successfully developed a medicine for this form of malaria since the 1950s. But now we’re trying to change that.
One of our potential medicines in development is designed to treat this type of malaria by preventing relapses – it’s called tafenoquine. Developed in partnership with Medicine for Malaria Ventures, tafenoquine has completed phase III clinical trials and in late 2017, we submitted regulatory applications for tafenoquine in the United States and in Australia.
"There is a pressing need to control malaria, and we are committed to play a role to support the WHO’s goal to end malaria for good. Developing a medicine or vaccine for the parasite is particularly challenging because it can evolve to outwit our best attempts to defeat it."
Alison adds “To achieve our goal, we believe it is important to collaborate with external partners so that we create an environment that stimulates the exchange of ideas for the benefit of patients. It’s an approach we are taking to develop our medicines and vaccines for malaria.”
30 years and counting: the quest for a vaccine
Fighting malaria demands an arsenal of weapons on which we can draw from preventative measures like bed nets to medicines, and potentially vaccines. Finding a vaccine against malaria is extraordinarily challenging because the plasmodium falciparum parasite, which causes the deadliest form of malaria in humans, is capable of adapting to the human host and escaping its immune responses.
But after more than 30 years of research, along with our partners, we are closer than ever to bringing a vaccine to young children in Africa. Following one of the biggest trials of its kind in sub-Saharan Africa, the European Medicines Agency gave our vaccine candidate, known as RTS,S, a positive scientific opinion in 2015. In late 2018, the WHO will embark upon a pilot implementation of RTS,S, with at least 360,000 children in Ghana, Kenya and Malawi being vaccinated through national immunization programs.
Our vaccine candidate is not a silver bullet against malaria – it is designed to complement and work alongside other tools such as bed nets and medicines. If approved for use, it would be offered at a not-for-profit price.
Making health systems more robust to fight malaria
When it comes to fighting malaria, we know what can work – preventative tools like bed nets, rapid diagnosis and treatment – but the hard part is making sure people can get access to these interventions where they need them, when they need them.
More health workers are needed to head out into remote communities, teaching them how to put up their bed nets and running rapid diagnostic tests. More healthcare facilities, with reliable supplies of medicines, are vital.
Partnerships are also critical when it comes to strengthening health systems as it needs a combination of government, civil society and business working together. So we have teamed up with Comic Relief, the UK charity, with whom we’ve created a £22 million fund to fight malaria.
Through the partnership, we are supporting 20 community projects with grants in sub-Saharan Africa and the Greater Mekong sub-region of south-east Asia. These projects range from youth-led approaches to training healthcare workers and volunteers – all with a view to helping people access prevention, diagnosis and treatment at the right time, in the right place.
If we maintain our momentum against malaria, Allan is hopeful that we can finally conquer this ancient killer: “By focusing our respective efforts and expertise on the disease, through being thoughtful and collaborative, we could help consign malaria to the history books.”