25 February 2019

Combating anti-malarial drug resistance

Facilitating the rapid availability of new antimalarial therapies

Resistance to antimalarial drugs is a potentially catastrophic global health threat. With new medicines years away, pragmatic short-term solutions are required. Development of Triple Artemisinin Combination Therapies (DeTACT), a new project funded by UKaid and DFID, combines drug components to create new medicines with extended therapeutic lifetimes. Researchers at the Copernicus Institute will develop strategic advice to facilitate the rapid availability of these new therapies on the African and Southeast Asian markets.

Malaria is a mosquito borne infectious disease caused by single celled Plasmodium parasites. Although its burden has been significantly reduced since the beginning of the century, the disease still takes almost half a million lives a year - mainly children in Sub-Saharan Africa. This is unacceptably high; malaria is easily preventable and effective medicines do exist. An important factor in the reduced burden has been the introduction of Artemisinin Combination Therapies (ACT) as the global first-line treatment.

Increasing resistance to current anti-malarial therapies

We are at risk of losing these therapies. Due to the emergence of resistance to artemisinin and partner drug combinations, malaria is becoming increasingly difficult to treat in Southeast Asia. There is an urgent call for action - this multi-drug resistance may spread to India and Sub-Saharan Africa, where the majority of the burden is situated. Previous episodes of antimalarial drug resistance have demonstrated the catastrophic potential of this scenario.

New antimalarial drugs are years away in the pharmaceutical pipeline

Consortium to develop and test new antimalarial drug combinations

To address this emerging health threat, the DeTACT consortium has been established to develop and test new anti-malarial drug combinations. Because new anti-malarial drugs are years away in the pharmaceutical pipeline, the consortium aims to combine components that are already in use, creating Triple Artemisinin Combination Therapies (TACT).

TACT is considered the most feasible short to medium term solution to tackle multi-drug resistant malaria. The idea is that combining components with reverse resistance mechanisms will extend their therapeutic lifetime. Once they are proven safe and effective, TACT can provide direct clinical relief to malaria patients in Southeast Asia, and delay the spread of resistance to Africa.

Pharmacy in the Congo. Photo: Freek de Haan

Strategic advice for rapid availability of TACT at affordable prices

At the Copernicus Institute, researchers Freek de Haan, Ellen Moors and Wouter Boon are exploring the positioning of these TACT combinations on the African and Southeast Asian markets. The research will provide strategic advice to facilitate the rapid availability of TACT in these regions at affordable prices, helping to combat the threat of multi-drug resistant malaria.