Image credit: Jon Farrow / Wellcome Sanger Institute
What if you had to live with the constant fear of being bitten by a mosquito that could infect you with a deadly disease? This is the reality for millions of people in 84 countries where malaria is endemic. Malaria preys on the vulnerable, with young children and pregnant women facing a high risk of infection and even death. Malaria is not only a health threat, but also a social and economic burden that costs an estimated $12 billion per year to individuals and governments.
In spite of the challenges posed by the COVID-19 pandemic, the global malaria community has shown remarkable resilience and commitment to fight this deadly disease. The 2022 World malaria report¹ revealed that malaria cases and deaths remained stable in 2021, thanks to the efforts of countries and partners to sustain and scale up essential malaria services. However, more needs to be done to achieve the global targets of reducing malaria cases and deaths by at least 90 per cent by 2030². With new tools and innovations on the horizon, such as the first WHO-approved malaria vaccine for at-risk children and new insecticide-treated bed nets, there is hope that we can accelerate progress towards malaria control and elimination in the coming years³.
Every year on April 25th, we observe World Malaria Day to raise awareness and mobilise action against malaria. This year, the World Health Organisation’s call to action focuses on three key areas: investing in the global malaria response, stepping up innovation, and implementing the strategies we have now. MalariaGEN and its partners are contributing to the global effort to tackle malaria by harnessing the power of genomic surveillance, and we’re taking a look at how this work aligns with the WHO’s three key areas.
Investment is an essential step to ensure that researchers are equipped with the tools and knowledge they need to effectively take on malaria. This is why MalariaGEN is helping counterparts in malaria-endemic countries to access procurement grants for essential lab equipment and specialist reagents, organising and delivering training programs with partners, and nurturing new generations of talent through research fellowships. These investments help to build up genomic surveillance capacity, but more importantly the human capacity that is central to the global effort to fight malaria.
The Wellcome Sanger Institute’s Genomic Surveillance Unit (GSU) and MalariaGEN are developing cutting-edge tools to build malaria genomic surveillance capacity worldwide. For example, selective Whole Genome Amplification (sWGA) is a game-changing technique developed in part by the GSU’s Dr. Cristina Ariani. sWGA can be used to extract whole Plasmodium falciparum genomes directly from bloodspots, rather than having to rely on vials of liquid blood. This means that with just a drop of dried blood on some filter paper and sWGA, you can obtain the malaria parasite’s whole genetic sequence. And the innovation doesn’t stop there – Cristina’s team is working on ways to extract DNA from other species of Plasmodium that cause malaria, like Plasmodium vivax. They’re also figuring out if they can extract DNA directly from rapid diagnostic tests to potentially bypass blood spot sampling altogether. If successful, these out-of-the-box innovations could drastically change the way malaria parasite samples are studied.
"For us to go through the intense training and be able to pass that down to other people, especially in Africa, is the objective. It's about being able to understand the whole process, the workflow of getting the data, how to curate and analyse the data, how to create data packages in-house, share with the public for reproducibility, and then being able to assist other people to do that. I think it starts somewhere, and applying for grants that create opportunities for people to be involved in the analysis of such data is an important step for capacity building."
One of the PAMCA (Pan-African Mosquito Control Association) Bioinformatics fellows currently seconded to the Sanger Institute’s Genomic Surveillance Unit
One of the big problems with fighting malaria is that we don't have enough tools and people to keep track of how the mosquitoes and the parasites change over time. This makes it difficult for national public health actors to know what kind of drugs and insecticides work best in different places. That's why MalariaGEN is working with partners to set up regional genomic sequencing hubs, which can implement genomic surveillance tools that enable quicker decision-making on the most suitable interventions to help vulnerable individuals in the region. One of these hubs is being set up in West Africa with support from the UK’s National Institute for Health and Care Research. At the hubs, partners can collect and sequence mosquito and parasite samples from the region, and share high-quality malaria vector and parasite data with national malaria control programmes and other stakeholders. By generating and analysing genomic data, the project aims to provide timely and actionable data to inform how we tackle malaria in West Africa and beyond.
While we have come a long way in controlling malaria, it remains a major threat to millions of people. We must continue to work together and build on the efforts of the global malaria community to attain the ultimate goal of zero malaria. The good news is that the tools and strategies to achieve this exist; all we need to do now is to invest, innovate, and implement them effectively.
Find out more
- 1. WHO World Malaria Report
- 2. WHO - Background to World Malaria Day
- 3. WHO recommends bed nets and vaccines
- MalariaGEN on Twitter
- The Genomic Surveillance Unit at the Wellcome Sanger Institute
- WHO Malaria Fact Sheet
- CDC - Malaria's Impact Worldwide
- PAMCA Bioinformatics fellows at the Wellcome Sanger Institute news story on MalariaGEN
- Genomic Surveillance Hubs in West Africa (NIHR Global Health Research Group)