Funding &Vector Control &World Malaria Day Bill Brieger | 10 Apr 2025 06:42 am
Global State of Malaria: New Research, Evolving Risks, and Silver Linings
In the lead up to World Malaria Day 2025, the Johns Hopkins Malaria Research Institute held an Expert Briefing for the Media to discuss the Global State of Malaria: New Research, Evolving Risks, and Silver Linings. The session was moderated by Ellen Wilson.
The two experts included Jane M. Carlton, PhD, director of the Johns Hopkins Malaria Research Institute at the Johns Hopkins Bloomberg School of Public Health and a Bloomberg Distinguished Professor in the Department of Molecular Microbiology and Immunology at the School and George Dimopoulos, PhD, MBA, also a professor in the Department of Molecular Microbiology and Immunology.
The speakers discussed and responded to questions regarding the current state of malaria, the need for global commitment to malaria prevention, control, and research, advancing diagnostics and therapeutics, current mosquito vector control methods and their limitations, and the need for an integrated approach to malaria control. As an overview, attendees were told that malaria is a mosquito-borne disease that in 2023 took nearly 600,000 lives in 83 countries, the majority being children under age 5 years in the WHO African Region. In the U.S., the risk of contracting malaria remains low; however, continued vigilance is needed to prevent increases in both domestic cases from foreign travel and as occurred in 2023 for the first time in 20 years, locally transmitted cases.
Jane Carlton expressed concern that malaria cases had increased from 2022 to 2023, but was hopeful because of innovations such as vaccines, and genetically modified mosquitoes. One could also draw hope from efforts to establish local manufacturing capabilities in endemic countries, including partnerships for African vaccine development and production. And in fact, she noted, in 2022, “one company in Kenya became the first African-based manufacturer to receive WHO pre-qualification for a malaria drug. There is a second Nigerian manufacturer that is making progress.” There are several research organizations and universities in African countries that are working towards new drug and intervention development. Studies are ongoing perhaps to use some local plants as anti-larval treatments.
Prof. Carlton explained that the burden of malaria in India has reduced dramatically. “There’s been about a 70% reduction in cases from just over 6 million in 2017 to 2 million in 2023,” although two million cases is still quite a large number.
Prof. Carlton was also asked about the effect climate change on malaria transmission and the potentially expanding the geographic range of malaria. How are researchers adapting? She observed that, “Yes, that’s a very interesting question. In fact, it goes against intuition in a way but increasing the temperature doesn’t always increase the number of malaria cases. The malaria parasite and the mosquito that carries operate within quite a tight temperature range.
In reality, it can get too hot, but as some areas get wetter and formerly cool areas become warmer due to climate change, malaria transmission can move to new locations. “So, there is an increasing shift and an increasing understanding that surveillance of this particular issue is important,” especially needing to monitor climate contexts. For example, scientists have looking at the invasive Anopheles stephensi, which is severely disrupting activities of National Malaria control programs.
There’s been an analysis from the Oxford Malaria Atlas Project, or MAP, and they have projected that with a freeze for one year of PMI activities, this would result in up to 18 million additional malaria cases and up to 107,000 additional malaria deaths. This represents an increase in morbidity of 13%. This would occur in PMI’s focus geographies across 27 African countries. This analysis doesn’t account for the additional impact of PMI supported diagnostics.
Prof. Carlton observed that “globally, total investments in malaria control reached an estimated $4 billion in 2023, but this already fell short of the $8 billion funding target” of the World Health Organization Roll Back Malaria Partnership.
George Dimopoulos stressed e importance of community engagement in vector control activities. He explained that malaria is one of the diseases of poverty where the poor are disproportionately at risk and impacted. He then responded to a question about gene-drive technology based on the
CRISPR-Cas9 system that can spread mosquito genes in natural populations. “This has advanced very significantly in mosquitoes over the past roughly 10 years.”
Prof. Dimopoulos explained that gene-drive “can also work in all malaria vector species. In this way it becomes a malaria control strategy that could work in all malaria endemic areas.” Prof. Dimopoulos’ team has also done research on the effects of sugars and micro-organisms on the mosquito gut and malaria transmission. “We have shown through our research that the health of the mosquito gut depends on a protein quality control system. With appropriate control interventions, “The mosquitoes become very sick and a large proportion of them will actually die.”
In conclusion, the “Silver Linings” mentioned in the session’s title include advances in both parasite and vector control. Deployment of two malaria vaccines offers one ray of hope. New vector control technologies such as gene-drive, offer another. The speakers encouraged people to attend the upcoming JHU-MRI Malaria Day conference to learn more.