Philip Welkhoff
Director, Malaria, Bill & Melinda Gates Foundation
Helen Jamet
Deputy Director for R&D, Malaria, Bill & Melinda Gates Foundation
For millennia, humans have been locked in a strategic game of chess with a formidable opponent—malaria. With hundreds of thousands of lives at stake each year, we can’t afford to lose.
When we make a move, malaria makes countermoves that challenge our best defences. As seen recently, one mosquito species, Anopheles stephensi, is literally on the move, bringing the disease to new environments in Africa.
Like chess, many pieces are on the board in the malaria fight. Drugs treat the disease; insecticides kill the mosquitoes that spread it; and vaccines are emerging to prevent infection. Yet, the tools we have today will not be enough to end malaria. Fortunately, game-changing tools are within reach, thanks to decades of investment in innovation and leadership from endemic countries.
New bed nets are saving lives
In the battle against mosquitoes, new bed nets using insecticide mixtures have proven more effective in preventing disease than standard nets, especially in areas with insecticide resistance. The World Health Organization recently recommended widespread deployment of these nets, which are already saving lives in communities.
Prevention is key, and researchers are making progress in developing effective tools for all ages.
Promising tools ahead
Prevention is key, and researchers are making progress in developing effective tools for all ages. Monoclonal antibodies are showing promise, as early-stage findings indicate a low-cost, single-dose antibody treatment could protect children and, eventually, adults. Additionally, innovators are leveraging recent advances in vaccine technology to create a more-effective, longer-duration, all-ages malaria vaccine.
What if we could stop malaria transmission altogether? Researchers are exploring gene drive — an innovative genome editing technology — to modify mosquitoes and prevent them from transmitting the disease.
A comprehensive strategy
Successfully ending malaria will require new tools but also improved systems, access to care and partnerships centred on malaria-endemic communities. More sophisticated monitoring systems, including genomic surveillance, are transforming how we track resistance and malaria transmission. This, paired with improved case management in communities, provides malaria programmes with a more holistic and nuanced picture of how and why malaria is spreading — which will inform tailored response and care within countries.
Malaria continues to challenge us, but we can gain the upper hand. As our opponent makes new moves, we must adapt our strategy and outsmart it with the tools we have now, while rapidly bringing new ones to the game. By investing in innovation today, we can beat malaria at its own game for good.