Treatment of malaria is scheduled to get a new boost with a therapy that seeks to clear the infection as well as blocking transmission of parasites that cause malaria.
Novartis and Medicines for Malaria Venture (MMV) have announced a shift to phase3 study for novel non-artemisinin combinations to treat uncomplicated malaria.
According to scientists involved, this combination contains an optimized formulation of lumefantrine- it can be administered once daily unlike the usual twice-daily administration.
The new treatment is expected to help Rwanda’s relentless efforts in the fight against Malaria coupled with growing resistance to current malaria treatments.
According to Rwanda Biomedical Centre, the country’s health implementation agency, malaria incidence dropped from 400 per 1000 in 2016 to 148 per 1000 in 2020.
The agency says the country has continued to witness a decrease in malaria cases from 4.8 million in 2017 to 1.8 million in 2020, a decrease in severe malaria from 18,000 in 2016 to 3,000 in 2020. Malaria related deaths decreased from 700 in 2016 to 148 deaths in 2020.
According to Novartis and Medicines for Malaria Venture (MMV), Malaria is primarily treated with artemisinin-based combination therapies (ACTs) such as artemether-lumefantrine. ACTs are still highly effective and well tolerated.
However, Novartis and MMV have warned that the increased frequency by which parasites with a slower response to artemisinin are observed in some parts of Eastern Africa (Rwanda, Uganda, and the Horn of Africa) points to an urgent need to develop a new non-artemisinin class of antimalarials to avoid a return to the high levels of childhood mortality last seen in the 1990s.
Janvier Murenzi a community health worker in Bidudu village, Kiziguro sector in Gatsibo district says, his 12year old son contracted malaria in September, “I gave him the dose as required but he didn’t get well. I had to change to a stronger dose. That’s when he healed,” he said, adding that the current anti malaria medicine is not effective due to increased resistance.
Murenzi also said that at least every month he handles over ten cases for Malaria patients.
“If there is new and stronger medicine against Malaria, we will possibly eradicate it,” he said.
“The emergence of artemisinin resistance demands urgent action to develop new antimalarials. We need non-artemisinin-based medicines with novel mechanisms of action against resistant parasites, and simple, easy-to-follow dosing schedules to help increase treatment adherence,” said Dr Sujata Vaidyanathan, Head Global Health Development Unit, Novartis.
“The earlier we have new compounds and the faster the world adopts them, the better chance we stand of beating resistance,” noted Dr Sujata.
Dr. Timothy Wells, Chief Scientific Officer, MMV says, “we are increasingly seeing parasites with decreased sensitivity to artemisinin, even in Africa.”
“If the Phase 3 trial is successful, this new combination will increase the number of options available to countries and help save the lives of children at risk of this devastating disease,” said Dr Timothy Wells.
According to Novartis and MMV, the Phase 3 pivotal trial is planned to start in 2023. It will compare the efficacy of ganaplacide/lumefantrine-SDF to the current ‘gold standard’ artemether-lumefantrine.
The trial will be conducted in collaboration with the WANECAM 2 consortium, and will include partner clinical sites in Burkina Faso, Mali, Gabon and Niger as well as other sites in sub-Saharan Africa.
Both Phase 2 and 3 studies receive funding from the European and Developing Countries Clinical Trials Partnership (EDCTP), which is supported by the European Union.
It should be remembered that Kenya and other ten countries on the continent have been administering a pilot RTS,S/AS01 (RTS,S) malaria vaccine recommended by the WHO for children aged 6months to five years.