World's largest malaria conference opens with research aimed at eradication

The world's largest malaria conference opened today in Nairobi, Kenya, with a call for substantial and sustained support for research to guide evidence-based policies and the development of new malaria tools, which together could save countless lives. The 5th Multilateral Initiative on Malaria (MIM) Pan-African Conference brings together 2,000 researchers, health workers, public health officials, policymakers and activists from across Africa and around the world. Kenya's Vice-President Kalonzo Musyoka opened the conference. The first MIM conference to be held in four years, it will highlight the latest research in malaria prevention and treatment.

"The theme of this year's conference is 'Building Knowledge for Action', but the key question for malaria is 'which knowledge for which action?'" said Adrian JF Luty, senior researcher at Radboud University Nijmegen Medical Center, the Netherlands, and chairman of the MIM conference Scientific Committee. "If we as a global community are to be ready to achieve eradication, we must invest in the science that can guide these efforts and provide the tools and methods that will make success possible"

Although preventable and treatable, malaria continues to be one of the world's most deadly and persistent diseases. 90% of all malaria deaths occur in Africa, and 85% of these deaths are among children under the age of five. Since the last MIM conference in 2005, the global community has made tremendous strides against the disease. Yet despite this progress, many African countries are struggling to meet Millennium Development Goal 6, which aims "to halt and begin to reverse the incidence of malaria," and are unlikely to meet the World Health Organization target to halve malaria mortality by 2010, it was noted.

"Over the past four years, new strategies coupled with unprecedented global attention and support from endemic country governments have increased access to malaria treatment and prevention for some of the world's most vulnerable communities," said Francine Ntoumi, MIM secretariat coordinator at the African Malaria Network Trust (AMANET). "However, we must continue to build a critical mass of scientists working on malaria in Sub-Saharan Africa, so that countries with the greatest burden are themselves setting the research agenda," she added.

Treatments themselves causing problems

Due to continued cost and availability challenges, those most at-risk for malaria often have limited access to proven prevention tools, such as insecticide-treated nets and access to the current gold-standard drug, artemisinin-based combination therapies (ACTs). As a result, the disease disproportionately affects poor rural communities in malaria-endemic countries.

At the same time, over-use of artemisinin monotherapies and irrational use of ACTs themselves are leading to increased drug resistance. Expanding access to insecticides and agricultural use of insecticides is also putting evolutionary pressure on mosquitoes to develop resistance to the most effective malaria control methods available: insecticide? treated nets (ITNs) and indoor residual spraying (IRS). New classes of insecticides and malaria drugs that overcome today's resistance are still in early stages of development, it was noted.

Voice of dissent says Africa not ready for vaccine

However, African countries are not prepared to receive the malaria vaccine yet, a scientist told the meeting. Wilfred Mbachama from the Laboratory for Public Health Biotechnology in Cameroon called upon governments in the continent to set up structures that would facilitate the vaccine to reach the grassroots. "Last minute rushes may interfere with the implementation and distribution of the vaccine," said Dr Mbachama, pointing out the trait as an attribute of most African countries.

Speaking in Nairobi, the researcher challenged African leaders to kick off necessary legislation before the vaccine arrives in their respective countries. He pointed out the lack of adequate storage facilities and other regulatory requirements as some of the obstacles to an effective roll-out of the vaccine.

"It is not simply receiving and using the vaccine," Dr Mbachama said, adding that it takes three to five years to develop capacity to obtain any vaccine. He cited that failure to adhere to instructions on the storage conditions of the vaccine would lead to denaturing of the product thus reducing the efficacy of the product.