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PAN4ND
Neglected Diseases - Malaria
Neglected Diseases - Malaria
Malaria
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Malaria is a major cause of morbidity and mortality worldwide, especially in developing
countries where it has serious economic and social costs. The disease is present in
over 100 countries and threatens half of the world's population.
Every year, 350 to 500 million cases of malaria occur worldwide, with over 1 million
deaths, affecting mostly children in sub-Saharan Africa. The child death rate from
malaria doubled between 1990 and 2002. Malaria remains the single largest cause of
death for children under five in Africa, where it kills one child every 30 seconds – this
translates to the deaths of approximately 3,000 children every day.
Malaria is caused by a parasite, called Plasmodium, that is transmitted from man to
man by the bite of anopheline mosquitoes. Four species of the parasite are involved:
Plasmodium falciparum, P. malariae, P. vivax and P. ovale. The most common and
most dangerous species is P. falciparum.
Malaria and poverty
Malaria and poverty are interrelated in a vicious circle:
- Malaria thrives where uncontrolled water spots and warm temperatures enable
Anopheles mosquitoes to breed, and where infected patients act as parasite
reservoirs. These conditions - which once existed in the United States, Australia and
Southern Europe - are common in many parts of the developing world.
- Malaria deepens poverty: patients are often bedridden and incapable of carrying
out normal daily activities. The annual economic growth in highly prevalent countries is
slowing down at an estimated rate of 1.3%. The economic cost of malaria in Africa is
estimated at $12 billion every year.
Treatments for malaria
Treatments exist but, in recent decades, drugs such as chloroquine or sulphadoxine-
pyrimethamine have become increasingly ineffective due to drug resistance.
Resistance to chloroquine now reaches over 90% in many parts of Africa. The spread
of resistance is a serious threat to global public health.
As a response to increasing levels of resistance to antimalarial medicines the World
Health Organization (WHO) since 2001 has actively encouraged malaria-endemic
countries to use combination therapies, preferably those containing artemisinin
derivatives (ACTs – artemisinin-based combination therapies), and to fixed-dose
combinations when possible.
Why the need for fixed-dose combinations?
Compliance to treatment is essential to ensure treatment effectiveness and to prevent
future resistance to ACT. But when combinations are provided as two separate drugs,
patients might take only of one the two drugs or fail to complete the whole course.
Taking one drug without the other increases the risk of resistance. Fixed-dose
combinations (FDC’s) combine two drugs into one tablet, instead of separate tablets,
to ensure that the patients take both drugs in the right dose. DNDi has been involved
in the development of two FDCs for malaria, including ASAQ.
What is the current state of drug R&D for malaria?
Between 1975 and 2004, only 7 of 1393 new chemical entities (NCE’s) approved were
targeted at malaria.
Worldwide, several compounds are at various stages of antimalarial drug development
around the world, with the Medicines for Malaria Venture (MMV) being a key partner in
many of these projects. Sanofi-aventis currently has several active projects. The most
advanced one is ferroquine, a compound that is active against chloroquine-resistant
falciparum and currently in phase II clinical development.
External Links
countries where it has serious economic and social costs. The disease is present in
over 100 countries and threatens half of the world's population.
Every year, 350 to 500 million cases of malaria occur worldwide, with over 1 million
deaths, affecting mostly children in sub-Saharan Africa. The child death rate from
malaria doubled between 1990 and 2002. Malaria remains the single largest cause of
death for children under five in Africa, where it kills one child every 30 seconds – this
translates to the deaths of approximately 3,000 children every day.
Malaria is caused by a parasite, called Plasmodium, that is transmitted from man to
man by the bite of anopheline mosquitoes. Four species of the parasite are involved:
Plasmodium falciparum, P. malariae, P. vivax and P. ovale. The most common and
most dangerous species is P. falciparum.
Malaria and poverty
Malaria and poverty are interrelated in a vicious circle:
- Malaria thrives where uncontrolled water spots and warm temperatures enable
Anopheles mosquitoes to breed, and where infected patients act as parasite
reservoirs. These conditions - which once existed in the United States, Australia and
Southern Europe - are common in many parts of the developing world.
- Malaria deepens poverty: patients are often bedridden and incapable of carrying
out normal daily activities. The annual economic growth in highly prevalent countries is
slowing down at an estimated rate of 1.3%. The economic cost of malaria in Africa is
estimated at $12 billion every year.
Treatments for malaria
Treatments exist but, in recent decades, drugs such as chloroquine or sulphadoxine-
pyrimethamine have become increasingly ineffective due to drug resistance.
Resistance to chloroquine now reaches over 90% in many parts of Africa. The spread
of resistance is a serious threat to global public health.
As a response to increasing levels of resistance to antimalarial medicines the World
Health Organization (WHO) since 2001 has actively encouraged malaria-endemic
countries to use combination therapies, preferably those containing artemisinin
derivatives (ACTs – artemisinin-based combination therapies), and to fixed-dose
combinations when possible.
Why the need for fixed-dose combinations?
Compliance to treatment is essential to ensure treatment effectiveness and to prevent
future resistance to ACT. But when combinations are provided as two separate drugs,
patients might take only of one the two drugs or fail to complete the whole course.
Taking one drug without the other increases the risk of resistance. Fixed-dose
combinations (FDC’s) combine two drugs into one tablet, instead of separate tablets,
to ensure that the patients take both drugs in the right dose. DNDi has been involved
in the development of two FDCs for malaria, including ASAQ.
What is the current state of drug R&D for malaria?
Between 1975 and 2004, only 7 of 1393 new chemical entities (NCE’s) approved were
targeted at malaria.
Worldwide, several compounds are at various stages of antimalarial drug development
around the world, with the Medicines for Malaria Venture (MMV) being a key partner in
many of these projects. Sanofi-aventis currently has several active projects. The most
advanced one is ferroquine, a compound that is active against chloroquine-resistant
falciparum and currently in phase II clinical development.
External Links