Throughout recent history, malaria medicines have repeatedly been compromised by antimicrobial resistance. Progress has been made over the last 20 years in bringing malaria under control through intensified use of a mix of control measures, including insecticide-treated bed nets and artemisinin-based medicines. Today, the utility of these interventions is again under threat.

As per Pillar 4 of WHO’s new strategy, it is crucial to prioritize investment in research and development to develop new combination therapies that do not contain artemisinin. 

In November of 2022, MMV and Novartis announced the decision to move a novel combination for adults and children with malaria to a Phase III study. This represents a major milestone in the effort to bring forward new medicines to combat antimalarial drug resistance. In addition, MMV's portfolio of antimalarial drugs contains 11 new compounds, all of which are active against current resistant malaria strains. 

Combatting resistance in the immediate future

As new drugs are being developed, resistance can be evaded in the immediate future by using multiple first-line drugs, either in parallel or in rotation, to reduce pressure on a partner drug. Lengthening treatment periods will also help maintain the drugs’ effectiveness. Additionally, adding low doses of primaquine, which can kill the stages of the parasite life cycle that are transmitted onwards, could also help limit the spread of resistance. 

Reducing risk and adding value

Research into new medicines is an invaluable insurance policy against the risk of malaria drug resistance. MMV, with partners, has been successful in replenishing the drug pipeline for malaria, and its experience and strategies developed are relevant to sparking R&D innovation for other diseases. The model at the base of MMV's work is the Product Development Partnership (PDP) model. 

PDPs use public and philanthropic funds to engage the pharmaceutical industry and academic research institutions in undertaking R&D for diseases that they would normally be unable or unwilling to pursue independently, without additional incentives. Partners share not only risks, but also costs, ideas and efforts, driving the discovery of new medicines and leading to tangible results.