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Mark Henley/ WHO 2016
How did you first get involved in the fight against malaria?
Malaria has always interested me – both the parasite itself and how the disease affects health systems and populations. My PhD work was actually originally on sleeping sickness, but in 1979 I started to work in the field and with communities in Africa. I realized what a huge problem malaria was for the people living there and I have been researching it ever since. I’m not just a scientist; I also assist running health programmes in resource-constrained environments. Earlier in my career I was focused on immunology and cell biology, but working in Cameroon, Liberia, and Tanzania really opened me up to the fields of epidemiology and public health.
I grew up on a farm, which was a very good learning experience and also made me very pragmatic. My research reflects this and is very diverse. I’m always moving between the field and the lab, the bush and the bench; it’s really the joy of my work. I think it’s good for people to get their boots dirty.
What research is most important to you?
Some of my research focuses on effectiveness studies – how you can bring efficacious tools most effectively to a community. Efficacy shows us whether or not a particular tool will work, but effectiveness shows us whether or not it can be applied. We have a good set of tools to fight malaria, but we need to improve our ability to combine and apply these tools in the best possible mix so that they will work well in a given context. It’s like mixing a cocktail, isn’t it? You must mix the cocktail just right, and a cocktail that works well in one bar might not work very well in another. (Laughs)
Can you talk about your experience with the first malaria vaccine trials conducted in Africa?
We have a good set of tools to fight malaria, but we need to improve our ability to combine and apply these tools in the best possible mix so that they will work well in a given context.
Dr Marcel Tanner
Pedro Alonso and I coordinated the first independent malaria vaccine trial in Africa in 1992. It was a very interesting process to go through. Though we ultimately concluded that the specific vaccine in its current formulation was not of public health use, the trials conducted created an important foundation for future vaccine development, with our findings inspiring and informing the conduct of subsequent trials as well as the review of respective WHO guidelines.
It is important as a global community for us to remember that while we focus on the result of a clinical trial, the lessons learned from the full spectrum of the clinical development process are also incredibly significant and contribute to a body of science with implications far beyond the trial itself.
What are some of the challenges facing the malaria community in the next five years?
I think we need our strategies to better focus on what needs to be done in countries, because that’s where the action happens. For example, we have the Global Technical Strategy for Malaria and we have the Action and Investment to defeat Malaria framework. Both are very good global documents, but I’d like to see us address more specifically how these documents can serve as a sort of guidance and umbrella for individual national operational plans.
The ability of the Global Malaria Programme to provide support to countries is very valuable. I’d like to see the Programme be able to expand its capacity to really work with people at the country level and create more opportunities for mutual learning for lasting change. It’s a simple principle: learning together is how we make a difference.
What do you think are some of the most important areas of research to focus on going forward?
Going forward, we will need to focus on creating new building blocks for combination therapy treatments, developing a single-dose malaria treatment, continuing to strengthen health systems and fight drug and insecticide resistance, conducting pilot implementation of the RTS,S malaria vaccine candidate, and maintaining strong public private product development partnerships for continuing research and development.
Continued political and financial support for a robust malaria research agenda is very important. Over the last twenty years, we’ve made good progress with insecticide-treated nets, diagnosis, and treatment. After all this progress, the hardest bits are yet to come. But these will also be the best bits, because it means we will be working towards elimination.