What happens to malaria research?

On an almost daily basis new research studies about malaria are published. What happens to these studies? In particular how does such research affect policies and programs? Wellcome Trust has reported that, “Research funded by the Wellcome Trust has helped shaped international and national health policy for two of the world’s most important public health challenges: malaria and dengue fever.”

kenya-malaria-risk-map-2009a.jpgWellcome points out that, “Research by Dr Noor from the Kenya Medical Research Institute-University of Oxford-Wellcome Trust Collaborative Programme has fed directly into the Kenyan government’s 10-year plan for the monitoring and evaluation of malaria,” which was launched in November 2009. This research contributed to a refined mapping of malaria in the country which will enable better targeted interventions.

The study by Noor et al. led to a “Model based geo-statistical methods (that) can be used to interpolate malaria risks in Kenya with precision … our model shows that the majority of Kenyans live in areas of very low P. falciparum risk. As malaria interventions go to scale effectively tracking epidemiological changes of risk demands a rigorous effort to document infection prevalence in time and space to remodel risks and redefine intervention priorities over the next 10-15 years.”

There is a history of WHO and the Tropical Disease Research Program conducting and using research to update malaria guidelines and policies. The 2004 document, “Scaling up home-based management of malaria: From research to implementation” explains that …

Large-scale research studies and pilot studies have shown that scaling up home-based management of malaria is both feasible and effective – and is already being implemented on a limited scale in some African countries. Research experience and demonstration projects have provided guidance on how home-based management of malaria can be scaled up to reach the majority of populations.

9241546948_eng.jpgIn developing malaria treatment guidelines in 2006 WHO explained that, “Wherever possible, systematic reviews of randomized trials that directly compare two or more treatment alternatives in large populations were identified and used as the basis for recommendations.”

The dissemination and adoption of research at the country level may be slow. The value of Artemisinin-based Combination Therapy (ACT) was proven by the time Roll Back Malaria was launched over ten years ago, but it took five or more years before some countries adopted this medicine as first-line treatment. Even after a new treatment policy was promulgated, the actual practice of ACT use by practitioners in the field lagged another 2-4 years.

Researchers themselves often need to learn how to become advocates for their own findings. The Future Health Systems Consortium has stressed the need for the research community to learn about “influencing health policy at various levels, either as a direct or indirect outcome of the proposed (research).”  FHS stresses the “need for systematic analysis of strategies to promote integration of research into policy processes.”

Research will definitely be a crucial component for progress along the pathway to malaria elimination. Vaccine research continues, new drugs must be discovered, and better net distribution mechanisms should be tested. We must always facilitate communication between researchers and policy makers to ensure progress along that pathway.

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