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Malaria Journal

, 11:316

Towards malaria elimination

Abstract

Over the past decade, there has been a transformation in the portfolio of medicines to combat malaria. New fixed-dose artemisinin combination therapy is available, with four different types having received approval from Stringent Regulatory Authorities or the World Health Organization WHO. However, there is still scope for improvement. The Malaria Eradication Research agenda identified several gaps in the current portfolio. Simpler regimens, such as a single-dose cure are needed, compared with the current three-day treatment. In addition, new medicines that prevent transmission and also relapse are needed, but with better safety profiles than current medicines. There is also a big opportunity for new medicines to prevent reinfection and to provide chemoprotection. This study reviews the global portfolio of new medicines in development against malaria, as of the summer of 2012. Cell-based phenotypic screening, and ‘fast followers’ of clinically validated classes, mean that there are now many new classes of molecules starting in clinical development, especially for the blood stages of malaria. There remain significant gaps for medicines blocking transmission, preventing relapse, and long-duration molecules for chemoprotection. The nascent pipeline of new medicines is significantly stronger than five years ago. However, there are still risks ahead in clinical development and sustainable funding of clinical studies is vital if this early promise is going to be delivered.

KeywordsDrugs Resistance Combinations ACT Endoperoxide Spiroindolone Relapse Transmission AbbreviationsACPR28Adequate clinical and parasitological response at day 28 post treatment

ACTArtemisinin combination therapy

AMFmAffordable medicines facility – malaria

Sino FDAChinese authorities

DHADihydroartemisinin

DNDiDrugs for Neglected Diseases initiative

EMAEuropean Medicines Agency

FDAFood and Drugs Administration

G6PDGlucose-6-phosphate dehydrogenase

IPTpIntermittent preventive treatment in pregnancy

MMVMedicines for Malaria Venture

SLSSublingual sugar

TPPsTarget Product Profiles

TDRUNICEF-UNDP-World Bank-WHO Special Programme for research and training in Tropical Diseases

WHOWorld Health Organization.

Electronic supplementary materialThe online version of this article doi:10.1186-1475-2875-11-316 contains supplementary material, which is available to authorized users.

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Autor: Melinda P Anthony - Jeremy N Burrows - Stephan Duparc - Joerg JMoehrle - Timothy NC Wells

Fuente: https://link.springer.com/







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