Malaria is one of humanity鈥檚 oldest killers, with of cases dating back to ancient Egypt. But despite efforts to eradicate the disease, a new from the World 91色情片 Organization estimates that nearly 600,000 people died of malaria in 2023, most of whom were children.
Progress in reducing the number of deaths has stagnated, with malaria cases increasing since 2018 because of a perfect storm of challenges. Growing resistance to insecticides and drugs has made prevention and treatment methods less effective. The rise in extreme weather events like flooding, caused by climate change, has allowed for the proliferation of new habitats for malaria-carrying mosquitoes. And funding shortfalls to the global agencies that bankroll and deliver key interventions have made it harder to ensure such measures reach those who need them in sufficient quantities.
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But despite these obstacles, we are continuing to innovate and make progress. This month marks one year since the rollout of the first malaria vaccine, RTS,S, which was followed by a second, R21, later in the year. R21 uses newer technology, making it cheaper to manufacture at scale, enabling faster deployment. These vaccines have now reached children in 17 countries, with more due later this year. Evidence from earlier pilot introductions of RTS,S in Ghana, Kenya and Malawi, where 2 million children have been vaccinated, has demonstrated and a 13 per cent reduction in deaths from any cause for young children.
But vaccines alone aren鈥檛 a silver bullet. As the malaria parasite continues to evolve, we need new innovations to defeat this ancient foe. This includes investment to future-proof core tools such as insecticides, replacing those that mosquitoes have evolved to resist, and new generations of life-saving treatments.
Promising new technologies are also in the pipeline, like gene drives, which genetically modify malaria-spreading mosquitoes by boosting inheritance of certain traits. Two options are on the table 鈥� amplifying genes that reduce the number of female Anopheles gambiae mosquitoes (those that spread malaria) or genes that prevent mosquitoes from passing on the parasite.
What makes gene drives particularly revolutionary is that, in theory, they would be self-sustaining. This is because the malaria-carrying mosquitoes themselves pass on these genes through the generations, limiting the need for repeat application by public health teams.
Other options include using a bacterial strain, , which can be carried in the gut of mosquitoes and can block the development of the malaria-causing Plasmodium parasite, mirroring an approach tested to control dengue virus.
Viable future tools like these, alongside existing ones, could save an estimated 13.2 million lives in sub-Saharan Africa over the next 15 years, according to in support of the , an awareness campaign. The work was done by my team at the MRC Centre for Global Infectious Disease Analysis at Imperial College London.
But scientists can鈥檛 do this alone 鈥� funding is urgently needed for research and development, and for rolling out these interventions. This year represents a crossroads moment, with both Gavi and the Global Fund, vital international health organisations responsible for ensuring help reaches those who need it, awaiting funding commitments from governments around the world.
Only with this support in place can we develop the full toolbox of malaria interventions we need and ensure they are distributed effectively. But if we can do this, we will be a step closer to ending a killer as old as the pharoahs.
Azra Ghani directs the MRC Centre for Global Infectious Disease Analysis in London
