Malaria eradication research agenda
The malaria eradication research agenda (malERA) identifies the new tools we need to develop, the implementation strategies that need testing, and the biological questions we need to answer in order to eliminate and eradicate malaria from the world. An overarching assumption of malERA is that the research community plays a crucial role in the fight against malaria and its eradication worldwide, and that eradication will be unachievable without the development of a new generation of tools and strategies to interrupt transmission.
The initiative to articulate a research agenda to eliminate and eradicate malaria began in 2008. The first malERA was published in 2011 (see monothematic series in PLOS Medicine 2011) and the updated malERA Refresh agenda was published in 2017 (see monothematic series in PLOS Medicine 2017). The first malERA highlighted a number of critical research areas, including Plasmodium vivax malaria, health systems research, new medicines combining both prophylaxis and radical cure.
After five years, a process to examine the progress made and the remaining and new research questions began through the 'malERA Refresh' consultations. The updated malERA Refresh agenda highlighted the progress made including positive scientific opinion for a malaria vaccine, advanced development of 3 non-pyrethroid insecticides, new genetic technologies with the potential to alter malaria parasite transmission by the mosquito, identification of markers of drug resistance, and development of Plasmodium vivax liver stage assays, as well as new collaborative approaches to mathematical modelling and screening for active ingredients for drugs and insecticides (see monothematic series in PLOS Medicine 2017). The malERA Refresh research agenda identifies where progress has been too slow and remaining gaps in our knowledge and in our tool kit - from understanding the role of low-density infections in maintaining transmission, to tools that can detect and clear hypnozoites, to tools that can tackle residual transmission, receptivity, and prevention of reintroduction.
The malERA Refresh collection is considered a complement to the WHO ‘Global Technical Strategy for Malaria’ (GTS) and the Roll Back Malaria ‘Action and Investment to defeat Malaria’ (AIM). Dr. Pedro Alonso, Director of the WHO Global Malaria Programme, underlined the importance of the updated agenda: "Robust research is critical for the WHO to build evidence-based policies and guidelines.”
Both malERA and malERA Refresh research agendas were produced through rigorous consultative processes with the participation of researchers, programme managers and policymakers.
The 2008-2011 malERA process involved more than 250 scientists and global health experts. It was organised around eight specific research themes and the monothematic series also includes two background papers on lessons learnt from previous malaria and other diseases eradication campaigns. The process was led by a Steering Committee, an International Advisory Committee and a Leadership Council comprising the Director-General of WHO, the President of the Global Health Program of the Bill & Melinda Gates Foundation, the Director of the US National Institute of Allergy and Infectious Diseases (NIAID); the Director of the Wellcome Trust and the Executive Director of the Roll Back Malaria Board. See more details about the malERA governance bodies. On the occasion of the publication of the malERA outcomes, the Leadership Council highlighted the importance of R&D for achieving the goal of malaria eradication, and called for active involvement and commitment from all actors, from research institutions to funding bodies (see malERA Leadership Council declaration).
The malERA Refresh consultations to examine progress and update the agenda were organised into six consultative panels involving over 180 experts. The themes of the panels were adapted from the original malERA, reflecting the evolution of the knowledge base even since the first malERA process in 2011. Each panel was guided by a chair and co-chair(s) who are renowned experts in their respective fields. The whole process was overseen by a Leadership Group.
Coordination and funding
The first malERA process was coordinated by a secretariat at the Barcelona Centre for International Health Research (CRESIB) and the malERA Refresh exercise was facilitated by the Malaria Eradication Scientific Alliance (MESA) which is hosted at the Barcelona Institute for Global Health (ISGlobal). Both malERA and malERA Refresh were supported by grants from the Bill & Melinda Gates Foundation. The outputs of the malERA processes are published in the open-access journal Plos Medicine.