EDCTP investment in malaria research

Research and development (R&D) for new and improved transformative tools is essential to achieve a world free of malaria. EDCTP is already supporting this R&D agenda with investments of €156 million under the second EDCTP programme (EDCTP2).

EDCTP2 has supported 65 projects on malaria research from large-scale international collaborative clinical research projects implemented by African-European research consortia to projects conducted by EDCTP Fellows who are leading the malaria research agenda in Africa.

The Global Health EDCTP3 programme, which was launched in 2021, builds on the work of previous EDCTP programmes, and has invested €25 million to date to support malaria-related collaborative research. In 2024, the programme has committed an additional €30 million in a dedicated call for proposals to support research on the existing malaria vaccines and the development of new promising malaria vaccine candidates.

Showcasing EDCTP-supported malaria research at MIM 2024

Throughout the MIM Society 8th Pan-African Malaria Conference (MIM 2024), EDCTP grant holders are presenting results from their studies. An overview of symposia, oral and poster presentations is available on the EDCTP at the MIM Society 8th Pan-African Malaria Conference page.

Vulnerable populations

Malaria disproportionately affects the most marginalised populations in society. According to the World malaria report 2023, the African region carries the heaviest burden of the disease – accounting in 2022 for about 93.6% of cases and 95.4% of deaths globally. Nearly 80% of all deaths in this region were among children aged under 5 years.

EDCTP’s malaria funding strategy has produced new interventions and tools to protect populations most at-risk, including infants and children, pregnant women and people with co-infections and co-morbidities. We invite you to read the below examples of EDCTP-funded research some of which are addressing the needs of these vulnerable populations.

New malaria treatment for infants under 5kg

Positive data from the phase II/III CALINA study, part of the PAMAfrica project, demonstrated that a novel formulation of Coartem^® (artemether-lumefantrine) developed for babies weighing less than 5kg has the required pharmacokinetic profile and good efficacy and safety to treat malaria in this vulnerable group. The data, which will be presented at the MIM 2024 symposium ‘Grassroots Mobilization to End Malaria: Integrating the care of the young infant’ on 26 April, have been submitted for regulatory review.

Malaria prevention in pregnant women

Malaria during pregnancy can cause serious maternal and newborn health issues, especially in women living with HIV. The World Health Organization recommends daily doses of the antibiotic co-trimoxazole to prevent malaria in pregnant women living with HIV residing in areas with high malaria transmission. However, its efficacy in sub–Saharan Africa is threatened because malaria parasites are becoming increasingly resistant to the drug.

Two EDCTP-funded studies, IMPROVE-2 and MAMAH, showed that the addition of the antimalarial drug dihydroartemisinin–piperaquine (DP) to daily co-trimoxazole substantially reduces the risk of malaria infection in pregnancy.

The symposium ‘New Evidence of Protection and Community Delivery of Intermittent Preventive Treatment of Malaria in Pregnancy’ taking place at MIM 2024 on 26 April 2024, presents the most recent evidence from the IMPROVE-2 and MAMAH trials.

Starting on 1 June 2024, the SAFIRE project is an ambitious adaptive platform trial project that focuses on the safety and efficacy of current malaria treatments during early pregnancy. As there is limited data on the safety and efficacy of existing treatment strategies, the project aims to generate scientific evidence that will inform treatment guidelines and clinical practice, and ultimately ensure that pregnant women have access to safe and efficient treatment options.

Extending primaquine use to children with malaria

The DPP project and its continuation IMPRIMA aim to improve children’s access to quality-assured primaquine. Several countries have already added primaquine to national guidelines as part of their malaria elimination strategy. Single low-dose primaquine has shown to be effective in blocking malaria transmission and can be used in individuals with G6PD deficiency. The DPP project is developing a child-friendly, flavoured formulation of primaquine that will be tested under the IMPRIMA project in Burkina Faso, Burundi and Madagascar. By engaging with local communities and policymakers, the project aims to support the adoption of single low-dose primaquine

The DPP and IMPRIMA projects were showcased in a symposium at MIM 2024 on 22 April 2024 titled ‘Implementing single low dose primaquine for transmission-blocking in sub-Saharan Africa: where do we stand & where are we going to counter the new threat of artemisinin partial resistance?

Fighting drug resistant malaria

Artemisinin-based combination treatments (ACTs) are the backbone of all currently recommended malaria treatments. The potential impact of widespread ACT resistance in Africa has been estimated at 16 million more malaria cases and nearly 80,000 additional malaria deaths annually. The MARC SE-Africa project is determining the extent of antimalarial resistance regionally and sharing the data with National Malaria Programmes and their implementation partners to protect the efficacy of current first-line malaria treatments.

The MARC SE-Africa project was featured in the symposium ‘Facilitating an integrated regional response to antimalarial drug resistance in South-East Africa’ that took place at MIM 2024 on 22 April 2024.

A second vaccine against malaria

The RTS,S/AS01 vaccine, the first malaria vaccine approved by WHO, is in high demand but supplies are currently limited. For this reasion, additional malaria vaccines are urgently needed. An EDCTP-funded phase II trial through the MMVC project demonstrated that the malaria vaccine, R21/Matrix-M, was highly efficacious, meeting WHO’s preferred 75% efficacy target. The results of a phase III multicentre trial were equally encouraging. In October 2023, WHO recommended the vaccine for the prevention of malaria in children, and in December 2023, R21/Matrix-M malaria vaccine was added to WHO’s list of prequalified vaccines.

The MIM 2024 symposium ‘R21/Matrix-M: a high-impact malaria vaccine’, organised by the University of Oxfortd (UK) on 22 April 2024, presented the R21/Matrix-M vaccine, its progress, data and plans.

Enhancing seasonal malaria control programmes

Seasonal malaria chemoprevention (SMC), where all children are given antimalarial drugs at times of the year when malaria transmission is most intense, is an effective strategy for reducing the burden of malaria. SMC has been adopted by multiple countries in sub-Saharan Africa, but coverage is suboptimal – only around half of eligible children receive SMC. The OPT-SMC project is working with National Malaria Control Programmes in 13 countries in West and Central Africa that have introduced SMC to improve the efficiency and coverage of national SMC programmes.

OPT-SMC is also working with the WHO Global Malaria Programme on the development of an SMC module within the health information system that all countries use for malaria surveillance. This will enable countries to better track and analyse their SMC activities.

Building scientific leadership to end malaria

A core element of all EDCTP programmes is capacity building to strengthen the science base in sub-Saharan Africa. This has included a substantial investment in human capacity through our extensive fellowship programme. Many EDCTP Fellows have gone on to assume leadership positions in African science and continue to generate high-quality research outputs on poverty-related infectious diseases, including malaria research. More information about our Fellows is available on the EDCTP Alumni Network platform.

In her Career Development Fellowship, the ISAMIMA project, Dr Azizath Mousilliou (Benin) aimed to evaluate the effectiveness of seasonal malaria chemoprevention (SMC) with the antimalarials sulfadoxine-pyrimethamine (SP) and amodiaquine (AQ) on malaria infection in children aged 6 to 59 months. The study, conducted in two villages of Benin, found that SMC contributed to a decrease in the prevalence of Plasmodium falciparum, but the prevalence of the parasite was still high. While other species of Plasmodium were also detected in addition to P. falciparum, these species seemed to be cleared by the SMC treatment. Additionally, it was detected that the level of some antibodies targeting Plasmodium was reduced by SMC.