Research Roundup: What we’re reading this week

Most of us know what it’s like to be bitten by a mosquito. For those of us in non-malarious countries, the itchy sensation afterward is more annoying than anything, but it eventually goes away. I think it’s probably also safe to say that most people know that malaria is spread by mosquito bites. However, what’s less talked about are the different species of malaria and the need for different treatments depending on the type one has. The most deadly type of malaria is Plasmodium falciparum, and is most common in sub-Saharan Africa. However, another type—Plasmodium vivax (P. vivax)—tends to be the most difficult to cure. P. vivax malaria lives dormant in the liver and can relapse, causing malaria again anywhere between a few weeks and several months after the initial bite. It’s most prevalent in South and South East Asia, Latin America, and the horn of Africa and is responsible for 70-390 million cases of malaria per year. You may be asking yourself, “what’s the point of me telling you all this?” At the tail end of 2013, we heard the news that an investigational antimalarial drug—tafenoquine—for the treatment and radical cure of P. vivax had completed a Phase IIb study. Tafenoquine is being developed by GHTC member Medicines for Malaria Venture (MMV)—a nonprofit working to reduce the burden of malaria by discovering, developing, and facilitating the delivery of new and effective antimalarial drugs—and the pharmaceutical company GlaxoSmithKline (GSK). The results of the Phase IIb study were published in The Lancet last December.   The most deadly type of malaria is Plasmodium falciparum, and is most common in sub-Saharan Africa. However, another type—Plasmodium vivax (P. vivax)—tends to be the most difficult to cure. P. vivax malaria lives dormant in the liver and can relapse, causing malaria again anywhere between a few weeks and several months after the initial bite. Photo: PATH/Evelyn Hockstein Shortly afterwards, in light of the preliminary clinical evidence and in response to GSK’s application, the US Food and Drug Administration (FDA) granted Breakthrough Therapy designation for tafenoquine. Under the designation, the FDA will work closely with the sponsors (GSK and MMV) to provide guidance to expedite the development of tafenoquine. If approved, tafenoquine offers the potential for a single dose option. However, tafenoquine still has to go through more clinical trials, and regulatory review and approval before patients are potentially able to receive treatment for P. vivax malaria. Regardless, both the completion of the Phase IIb clinical trial and it being designated FDA Breakthrough Therapy status are encouraging news that should be told. It’s true there has been much progress in fighting malaria over the years, but hundreds of thousands of people still die each year from P. falciparum and many more suffer the subtle, chronic effects of repeated infection with P. vivax so further research efforts to tackle malaria are still required. Global health research has created lifesaving health tools that have contributed to some of the most astounding public health successes—both domestically and abroad. Research such as that being taken on by MMV and other nonprofit product developers should be supported so that new and much-needed technologies can be developed and eventually accessed by those that need them most. Research in malaria is clearly needed to develop additional tools in the arsenal against a potentially deadly mosquito bite.

In this regular feature on Breakthroughs, we highlight some of the most interesting reads in global health research from the past week. The University of Dundee in Scotland has developed a new antimalarial compound in their Drug Discovery Unit that has been selected by GHTC member Medicines for Malaria Venture (MMV) for further preclinical development. According to Dr. Kevin Read, co-project leader at University of Dundee, the compound will now undergo scale-up and further testing with the goal of entering human clinical trials in the next 18 months. In a Q&A, PATH Technology Solutions Program Leader Anurag Mairal writes about product development and distribution challenges in global health. Mairal writes: “The biggest challenge with all of these great innovations is that they’re sometimes disconnected from the realities of what is needed on the ground in low-resource settings. The hurdles that innovative ideas face before they can become a sustainable global health solution are many.” The US government has launched a new initiative to prevent, detect, and respond to infectious disease threats around the world. The initiative aims to improve security at infectious disease laboratories, strengthen immunization programs, and set up emergency response centers to deal with outbreaks. The Lancet writes about the progress made in the tuberculosis drug pipeline, and the implications for future treatments against the disease. The author notes that while recent developments have been very promising, the health of the pipeline rests in nine candidates—all of which are still in preclinical development.