The 2010-2020 decade witnessed a renewed call for action to scale up the fight against malaria. While recent World Malaria Reports indicate positive trends towards reducing malaria cases, they caution that progress towards zero malaria remains slow and accelerated change is necessary. The next decade 2020-2030 is a crucial one as many commitments made in the last decade to eliminate the disease are working with a 2030 deadline. This includes the Agenda 2030 and the Sustainable Development Goals.
Ever since the emergence of the COVID-19 pandemic, countries have been scrambling to mitigate its social and economic effects, as well as find treatments and vaccines to save lives and protect their population. Even though some countries are reducing lockdown measures and re-starting their economies, the number of cases and victims continue to increase in several parts of the world, in particular in malaria-endemic countries.
The sense of urgency to prevent and treat other communicable fatal diseases has changed, as time and financial resources are diverted to find vaccines and treatments to coronavirus. According to The Global Fund, three-quarters of 106 countries reported disruptions on current programmes to prevent and treat HIV, tuberculosis and malaria.
On June 30th, the U.S. President’s Malaria Initiative (PMI) is celebrating its 15th Anniversary. PMI, one of the most prominent organisations fighting malaria worldwide, was created by the former-US President George W. Bush, back in 2005. Since then, the initiative has been working to give children a healthy childhood and break the cycle of disease and poverty in places where malaria is endemic.
During the last 15 years, PMI played a vital role in providing financial and technical resources. In 2019 alone, they spent USD$ 729 million in initiatives across 24 countries in Africa and three different programmes on the Greater Mekong Subregion in South East Asia. Altogether, these regions represent 90% of the global malaria burden.
The Crisanti lab has been accustomed to facing difficult and unexpected situations threatening our mosquito colonies, such as drastic failures in the system that controls temperature and humidity in the insectary, and the spread of microsporidia infections. We never would have imagined that a pandemic was next on the list!
In response to the COVID-19 crisis, on 18th March 2020, Imperial College announced that only essential research and operational activities would be permitted, and that building access would be restricted. Gone were the days of a 22-strong team of researchers; new regulations stipulated no more than 5-6 people in the insectary facility and a mandatory two-week quarantine for those showing COVID-19 symptoms.
Thankfully, the Crisanti lab was prepared: in February, as the virus hit the UK, we had put together a science-saving plan with military precision.
At Target Malaria, the principle of co-development guides our work. Local communities do have a voice. They play a vital role in the development of our processes and research activities. This two-way dialogue helps us build a trustful relationship, ensuring that all residents’ concerns are addressed, and the technology we are developing will meet their expectations.
In Bana, a village in the Western part of of Burkina Faso, engagement activities with residents started in 2012, when the project started. Since then, the community has been supporting us collecting, releasing and recapturing mosquitoes – all part of our entomological studies.
Target Malaria started its work in Ghana in 2018, in partnership with the University of Ghana, Legon.
Different from other African countries where Target Malaria is present, Target Malaria Ghana does not have plans of working with modified mosquitoes. Instead, one of the main areas of research of our work is to understand what could happen if the population of Anopheles gambiae mosquitoes, the primary vector of malaria in sub-Saharan Africa, were to be substantially reduced or eliminated. This is part of the project’s commitment to responsible research: we need to ensure that if we were to release modified mosquitoes in the environment in the future, they would not harm the environment or our health.
The development of a local DNA barcode reference library of insects is part of Target Malaria Ghana’s activities. It will help answer a wide range of ecological questions that are not restricted to our project. Using samples collected from our studies sites, the research will shed light on the interactions among communities of arthropods and vertebrates, building a quantitative ecological network that enables the modelling of Anopheles gambiae’s impact on the ecosystem.
Controlling mosquitoes is a vital part of any integrated strategy to fight malaria. Target Malaria team at the laboratory of Professor Andrea Crisanti at Imperial College London has been working on developing novel genetic technologies as a tool to fight the disease and to complement existing vector control methods. Our strategy focuses on decreasing the number of female vector mosquitoes in a population because only females bite and transmit the disease, and their number usually determines population size and transmission rates.
There are two approaches to control the number of mosquitoes in a population. One way is to impact the ability of mosquitoes to reproduce, for instance by generating infertile females. Another method is to unbalance the male-to-female ratio generating a unisexual population leading to collapse. Achieving a male-only mosquito population has been the holy grail of vector control for long time.
We are pleased to announce that the team has been able to generate a driving male-biased sex distorter and eliminate caged populations of Anopheles gambiae mosquitoes. This is the subject of a paper just published in Nature Biotechnology, of which I am proud to be the lead author, entitled “A Male-biased Sex-Distorter Gene Drive for the Human Malaria Vector Anopheles gambiae”.
Back in 2016, the WHO Strategic Advisory Group on Malaria Eradication (SAGme) received the task to evaluate future scenarios for malaria, including whether it was feasible to eradicate the disease. Few years have passed, and after in-depth analysis and numerous consultations with malaria and health experts, the research outcomes are finally available.
The new report “Malaria eradication: benefits, future scenarios & feasibility” reaffirms WHO’s goal to eliminate the disease and reminds us that a malaria-free world is possible – if all of us commit to it. After considering factors and trends, members of the SAGme reached a consensus: the elimination of the disease would save millions of lives and generate substantial investment return. In terms of the feasibility of eradication, the experts concluded that theoretically no biological (on part of parasite, vector, or human host) or environmental limitations exist to prevent eradication. However, they note that available tools are not sufficient and that new tools must be found to achieve this eradication.
For us at Target Malaria, these findings come with no surprises. Our daily work is motivated by the belief that malaria’s social and economic burden can be eliminated, and that we should do everything in our power to prevent mosquito bites to threaten people’s lives.
The 2020 World Malaria Day taking place on April 25 comes at a challenging time when the world is grappling with the COVID-19 pandemic.
In a statement released on March 25, the RBM Partnership to End Malaria stresses “the need to maintain malaria elimination efforts throughout COVID-19 pandemic” and emphasizes why resilient and robust health systems are necessary now more than ever as the world faces emerging pandemics while having to protect vulnerable populations against existing threats, including malaria.
Physical gatherings will not be taking place in order to guarantee the imperatives of social distancing to prevent the spread of the virus, the day will still be celebrated virtually. WHO and the RBM Partnership are promoting a grassroot campaign “Zero Malaria Starts with Me”, which seeks to mobilize political support and empower communities to take ownership of malaria prevention and care.
To celebrate World Malaria Day, we would like to share with you the profiles of Target Malaria’s champions: our project’s Principal Investigators in the countries and at the global level.
Each of them is a malaria champion making a contribution to the fight against malaria day by day in his work.
Learn more about their personal and professional stories:
Principal Investigator of Target Malaria Ghana and Senior Lecturer in Medical Entomology & (…)
Principal Investigator of Target Malaria and Professor of Evolutionary Genetics at Imperial College London (…)
Principal Investigator of Target Malaria in Mali and Head of Genomics laboratory at MRTC (…)