Aligning anti-malarial drug research Since 2007, the Global Malaria Action Plan (GMAP) has focused on eliminating and ultimately eradicating malaria. An EU-funded initiative came to extend this work by identifying, in a logical and aligned way, robust research and development (R&D) programmes geared towards developing new tools, assays, and drugs. Health © Thinkstock Nearly half of the world's population lives in areas with some risk of malaria transmission. Chemotherapy is the central strategy for malaria treatment and control. This is hampered by the evolution of parasite resistance to current drugs. Recent introduction of combination treatments containing artemisinin has greatly improved the treatment of malaria. The number of new chemical entities in development points to a promising future for new anti-malarial drugs. However, the majority of candidate compounds are dropped before reaching the clinic. Only 1 out of 10 compounds that have reached Phase I clinical trials end up receiving regulatory approval. Most pharmaceutical companies have abandoned R&D on anti-malarial drug discovery and development due to poor financial returns, and current drugs in development don't really address the eradication agenda. The few European and international initiatives that do engage in anti-malarial research are hampered by fragmented and uncoordinated programmes and lack of communication. An urgent need was recognised to develop measures for identifying and integrating research priorities to produce drugs that conform to internationally acceptable methods. Seeking to address this, the EU-funded 'Coordination, rationalisation and integration of antimalarial drug discovery initiatives' (CRIMALDDI) project brought together a consortium of African and European anti-malarial drug discovery and development centres. The key objective was to produce a coordinated action plan for future research programmes and to identify gaps in the current programmes and plans. Through a series of meetings, conferences and especially facilitated workshops, partners collated information on current anti-malarial drug development initiatives worldwide, current needs and gaps, future research, and funding plans. Specific attention was given to mechanisms, enabling technologies (e.g. assays and screening methods), and support systems that need to be established or improved in order to accelerate the drug discovery and development process. The CRIMALDDI recommendations included developing new and rapid screening methods and assays for all species of the malaria parasite and all stages of its lifecycle, elucidating the mechanism of artemisinin resistance, identification of new drug targets and how to handle most efficiently the results of high-throughput screening of candidate compounds. The sharing of resources and technologies was also emphasised. The consortium produced a five-year action plan for generating new drugs and screening technologies needed to control and potentially eradicate malaria (http://www.crimalddi.eu/documents/BusinessPlanfinal.pdf). The outputs of the CRIMALDDI project were published (http://www.malariajournal.com/content/9/1/202) and presented to the European Commission at a workshop in Brussels and recommendations were made to reduce unnecessary overlap between different research groups. Precise costing and timeline analysis will determine the implementation of the CRIMALDDI project proposals.
