The path to a malaria-free world

Malaria is a challenging disease, but it’s beatable.

Over the past few decades, investments across sectors helped drive down case and death rates. The global death toll fell by nearly 40% between 2000 and 2015. Unfortunately, that number increased in 2020 due to COVID-19 disruptions—which should signal all of us to recommit to supporting patients and creating a malaria-free world.

The history of how antimalarials came to be illuminates the importance of the biopharmaceutical industry in bringing science to scale for populations, and I wanted to share that inspiring story alongside perspectives for the path forward.

A biblical disease  

Malaria has been a scourge on humanity since biblical times. The earliest fossil records of malaria date back 30 million years, and the earliest sign of malaria in human populations goes back to 3200 B.C. Malaria is described in ancient texts from Mesopotamia, India, China, the Greeks, and the Romans. Homer mentions malaria in the Iliad, as do Aristotle and Plato in their writings.  

In 200 BC, over 2,000 years ago, a remarkable event happened. In an ancient Chinese medicine text called Recipes for Fifty-Two Ailments, a treatment for malaria was described using a plant, a sweet wormwood called Artemisia annua. Other medical texts in China over the centuries would mention this remedy. However, use of the plant was limited to traditional Chinese medicine.

A Nobel-Prize-winning discovery

In the 1970s, Tu Youyou led an effort to discover new antimalarials. Given the toll malaria had taken on global populations, scientists had already screened hundreds of thousands of compounds without success. She decided to take a different approach—she screened Chinese herbs for their antimalarial properties.    

Following the trail of ancient Chinese medicine texts, she eventually came upon a highly active compound: Artemisinin, extracted from the very same Artemisia annua. After extensive work, she published her work in 1979. Tu was awarded The Nobel Prize in Physiology or Medicine in 2015.

A longstanding commitment by Novartis

In the 1980s, Novartis began an ambitious project to take Tu’s findings and translate them into a medicine that could be brought to the world. In the 1990s, we initiated clinical trials. We and others figured out how to move from harvesting the plant to chemically synthesizing the medicine, and Novartis eventually brought the medicine forward.

To-date, we’ve delivered more than 1 billion courses of antimalarial treatment, including over 450 million pediatric treatments, largely at no profit since 1999. 

Deaths from malaria have been reduced dramatically since the introduction of these medicines, and the suffering brought on by the disease has been extraordinarily reduced as well.

A collective path forward

Eradicating malaria is a challenge too big for any one organization. The time I spent working in The Gambia and Tanzania over 20 years ago convinced me that eliminating malaria depends on robust and responsive health systems. That means well-trained medical workers with the equipment and facilities to prevent, diagnose, and treat malaria, as well as robust supply chains to halt the entry of counterfeit medicines.

Below are three interventions we can consider for the path forward.

Firstly, we must continue to partner on research and development, including through nonprofit, public-private partnerships like the Medicines for Malaria Venture. Among other efforts, last year Novartis renewed our commitment to tropical disease and malaria elimination and announced that we’d invest $250 million over five years for related R&D efforts.

We are also the only biopharmaceutical company with a novel antimalarial in late-stage development for treatment of malaria caused by the deadliest parasite, plasmodium falciparum, and we’re bringing forward a new antimalarial formulation for babies under 5kg.

Innovation is especially important to ensure we can thwart the threat of artemisinin resistance and continue to meet the needs of underserved populations. 

Secondly, we must use technology to support related efforts where malaria is endemic. Technology can aid the fight against disease, whether it’s through ensuring local clinics have phones and internet to manage supply chains or using data science and AI to track the disease’s spread through surveillance efforts across certain regions.

Thirdly, we must widen access to needed treatments and ensure we are optimizing all available tools to save lives. Novartis will keep working to widen access to our medicines and partnering to be part of the solution across malaria-endemic areas.

If we take a robust, collective approach, I am confident that one day we won’t need to mark World Malaria Day because we will have eliminated the disease from our planet.