El 12 de mayo de 2017 celebramos en la Fundación Ramó Areces una jornada con IS Global y Unitaid sobre enfermedades transmitidas por vectores, como la malaria, entre otras.

1. CRITICAL R&D AND INNOVATION
NEEDS FOR MALARIA
Pedro Alonso, Director GMP

2. What a difference 15 years makes
• 262 million malaria cases
• 839,000 deaths
• No significant vector control
• Chloroquine resistance.
• Limited diagnostic testing available.
• No IPTp, IPTi or SMC
• Limited new product pipeline.
• No significant international funding.
• Limited political will and financial
resources.
2000
• 214 million acute cases
• 438,000 deaths
• 200 million new LLINs distributed
• 135 million people protected by IRS.
• 331 million ACT courses.
• RDTs
• Targeted interventions for highest risk
populations: IPTp, SMC
• Promising pipeline of diagnostics, drugs,
vaccines, delivery strategies and innovative
vector control tools.
• The Global Fund and the President’s Malaria
Initiative disburse > $1 Billion/Year
2015

3. 2000 – 2015: unprecedented progresses: innovation

4. Global trends in malaria incidence and mortality

5. Malaria interventions – ITNs, IRS, ACTs – are responsible for most
of the decreases in malaria since 2000

6. 0
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2016
2017
2018
2019
2020
2021
2022
2023
2024
2025
2026
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2029
2030
Annualglobalcost(US$inbillions)
Programme
Chemoprevention
Vector Control
Diagnostic testing
Surveillance
Treatment
Vision: A world free of malaria
Goals Milestones Targets
2020 2025 2030
1. Reduce malaria mortality
rates globally compared
with 2015
>40% >75% >90%
2. Reduce malaria case
incidence globally
compared with 2015
>40% >75% >90%
3. Eliminate malaria from
countries in which malaria
was transmitted in 2015
At least 10
countries
At least 20
countries
At least 35
countries
4. Prevent re-establishment
of malaria in all countries
that are malaria-free
Re-
establishme
nt
prevented
Re-
establishme
nt
prevented
Re-
establishme
nt
prevented

7. THE CHALLENGES: pyrethroid resistance

8. THE CHALLENGES: Insecticide resistance
• Mosquito resistance to at least one insecticide reported from 60 countries
• A WHO-coordinated 5-country evaluation showed that ITNs still remained effective

9. • Development of insecticides with new modes of
action
• Development of strategies for the use of new
insecticides that minimise emergence of resistance
• Further development of practical and reliable methods
to monitor insecticide resistance
• Further work on interpreting insecticide resistance
data and on its use to inform resistance management
action
• Supporting wider implementation of integrated vector
management, including further research on targeting
of new tools and their combined use
Insecticide Resistance Needs

10. THE CHALLENGES: Residual transmission of Malaria
Durnez & Coosemans 2013. Residual transmission of malaria: an old issue for new approaches. In
Anopheles Mosquitoes – New insights into malaria vectors, Editor Sylvie Manguin, Intech

11. • Better understanding of what constitutes residual
transmission and how this varies between locations
• Development of new tools to control vectors that do
not rest or feed indoors and are therefore not
susceptible to current core interventions (LLINs & IRS)
• New approaches that permanently reduce the high
vectorial capacities of dominant malaria vectors,
including genetic control
Residual Transmission Needs

12. • Generate a better understanding of how to measure
impact of insecticide resistance
• Determine the utility of entomological surrogates to
predict epidemiological outcomes
• Better entomological intelligence on vector behaviour,
measuring transmission and implications of these and
other factors on residual transmission and how to
eliminate malaria
• Tracking of mosquito populations and movement to
monitor effect of interventions such as genetic control
• Generate comparative cost-effectiveness data to assist
programmes in the prioritization and deployment of new
tools
THE CHALLENGES: Monitoring & Evaluation

13. Thank you