2 new malaria treatments show promise as drug resistance grows – The Hill

Advancements in Malaria Treatment and Their Impact on Sustainable Development Goals

The Global Health Challenge of Malaria and SDG 3

Malaria remains a significant impediment to global health and development, disproportionately affecting vulnerable populations, particularly children in sub-Saharan Africa. The persistence of this mosquito-borne disease directly challenges the achievement of Sustainable Development Goal 3 (Good Health and Well-being), specifically Target 3.3, which calls for an end to the epidemic of malaria by 2030. Progress is threatened by the parasite’s growing resistance to frontline artemisinin-based therapies. This health crisis also undermines other SDGs, including SDG 1 (No Poverty) and SDG 4 (Quality Education), by incapacitating workforces and causing children to miss school.

Analysis of New Therapeutic Approaches

Recent research presented at the American Society of Tropical Medicine and Hygiene conference highlights two promising strategies to counteract drug resistance and advance the goals of SDG 3.

1. Novartis’s Next-Generation Treatment: GanLum

   A new drug combination developed by Novartis represents a critical advancement in the fight against resistant malaria strains.

   • Composition: A combination of a new drug, ganaplacide, and an existing medication, lumefantrine.
   • Efficacy: A study involving 1,700 individuals across 12 African nations demonstrated a cure rate exceeding 97%. The treatment was also highly effective against mutant parasites with partial drug resistance.
   • Contribution to SDGs: By providing a new class of effective drugs, GanLum is vital for sustaining progress towards SDG 3. A healthy population is foundational to achieving SDG 8 (Decent Work and Economic Growth).
   • Implementation Details: The treatment is administered as a three-day course. The company is working to improve its taste to enhance patient adherence, a key factor in successful public health outcomes.

2. Single-Dose Combination Therapy

   A separate study in West Africa tested a single-dose regimen to improve treatment completion rates, a major challenge in malaria control.

   • Composition: A single dose combining an artemisinin with three other antimalarial drugs (pyronaridine, sulfadoxine, and pyrimethamine).
   • Efficacy: In a study of over 1,000 patients in Gabon, the single-dose treatment achieved a 93% cure rate after 28 days, comparable to the standard three-day course.
   • Contribution to SDGs: Simplifying treatment to a single dose directly addresses patient adherence issues, making therapy more effective and accessible. This contributes to SDG 3 and helps reduce health inequalities, a core principle of SDG 10 (Reduced Inequalities).
   • Future Development: Discussions are underway to produce the four-drug combination in a single, inexpensive format to maximize its public health impact.

Challenges to Achieving SDG Targets

While these therapeutic advancements offer significant hope, several challenges threaten the global community’s ability to meet its malaria-related SDG targets. These challenges underscore the importance of SDG 17 (Partnerships for the Goals) to ensure a coordinated and sustained global response.

• Funding Shortfalls: Reductions in funding from key international donors could severely impact the capacity of affected countries to monitor drug resistance, implement prevention programs, and distribute essential treatments.
• Parasite Resistance: The malaria parasite’s ability to evolve and develop resistance to new drugs remains a constant threat, requiring continuous investment in research and development.
• Treatment Adherence: Ensuring patients complete multi-day treatment courses is a persistent operational challenge that can accelerate the development of drug resistance if not properly managed.

Analysis of Sustainable Development Goals in the Article

1. Which SDGs are addressed or connected to the issues highlighted in the article?

• SDG 3: Good Health and Well-being: The entire article is centered on combating malaria, a major global health issue. It discusses the disease’s impact, particularly on children in sub-Saharan Africa, and the urgent need for effective treatments to prevent severe complications and death.
• SDG 9: Industry, Innovation, and Infrastructure: The article highlights scientific research and innovation as crucial tools to fight malaria. It details the development of a “new class of drugs” like GanLum by Novartis and the experimental study of a new four-drug combination, showcasing the role of research and development (R&D) in addressing health challenges.
• SDG 17: Partnerships for the Goals: The article implicitly and explicitly points to the importance of collaboration. It mentions partnerships between a private company (Novartis), a non-profit organization (Medicines for Malaria Venture), academic experts (Johns Hopkins University), and international bodies (World Health Organization) to develop, test, and hopefully deploy new malaria treatments.

2. What specific targets under those SDGs can be identified based on the article’s content?

• Target 3.3: “By 2030, end the epidemics of AIDS, tuberculosis, malaria and neglected tropical diseases…” The article’s focus on developing new, more effective treatments to counteract drug-resistant malaria directly contributes to the global effort to end the malaria epidemic. The article notes that after new drugs were introduced at the beginning of the century, there was a “dramatic decline in global malaria death rates,” showing how medical advancements support this target.
• Target 3.b: “Support the research and development of vaccines and medicines for the communicable and non-communicable diseases that primarily affect developing countries…” The development of the experimental drug GanLum and the research into a single-dose, four-drug combination are prime examples of R&D efforts for malaria, a disease that, as the article states, has its “largest death toll in recent years… in children in sub-Saharan Africa.”
• Target 9.5: “Enhance scientific research, upgrade the technological capabilities of industrial sectors in all countries… encouraging innovation…” The work by Novartis to create a “next-generation treatment” and the study led by Dr. Ghyslain Mombo-Ngoma on a novel drug combination are direct instances of enhancing scientific research and encouraging innovation to solve a persistent problem like drug resistance.
• Target 17.16: “Enhance the global partnership for sustainable development, complemented by multi-stakeholder partnerships that mobilize and share knowledge, expertise, technology and financial resources…” The article mentions the collaboration between Novartis and the Medicines for Malaria Venture, as well as the involvement of experts from Johns Hopkins and the WHO. These partnerships mobilize the financial resources, scientific expertise, and technology needed to bring new drugs to fruition.

3. Are there any indicators mentioned or implied in the article that can be used to measure progress towards the identified targets?

• Malaria Death Rates: The article explicitly mentions historical death rates (“malaria killed more than 1.8 million people per year”) and notes that rates have “plateaued or even started to rise in some parts of the world.” This is a direct indicator for measuring the overall success in combating the disease (Target 3.3).
• Treatment Cure Rates: The article provides specific data points that serve as indicators of treatment effectiveness. For the four-drug combo, “93% of patients who received the one-time treatment were free of parasites.” For GanLum, it “was found to have a cure rate of better than 97%.” These percentages are clear metrics for evaluating new medicines (Target 3.b).
• Prevalence of Drug Resistance: The article is framed around the problem of the parasite’s “growing resistance to medication” and “partial resistance” to artemisinin-based drugs. Monitoring the level and spread of drug resistance is an implied indicator of the urgency and necessity for innovation (Target 9.5).
• Funding for Malaria Programs: The concern raised by the WHO expert that “funding from the United States and some other sources is being cut” implies that financial investment is a key indicator. These funds are necessary for monitoring drug resistance and making treatments available, thus measuring the strength of global partnerships and commitment (Target 17.16).

4. Summary Table of SDGs, Targets, and Indicators

Source: thehill.com