Cookies on this website

We use cookies to ensure that we give you the best experience on our website. If you click 'Accept all cookies' we'll assume that you are happy to receive all cookies and you won't see this message again. If you click 'Reject all non-essential cookies' only necessary cookies providing core functionality such as security, network management, and accessibility will be enabled. Click 'Find out more' for information on how to change your cookie settings.

The malaria parasite is a highly evolved and complex organism, a ‘master of disguise’. Whilst the development of a vaccine has proved difficult, targeting a pathway essential for the parasite has led to the neutralisation of all strains of Plasmodium falciparum. This is an important step towards developing a vaccine against one of the world’s major killers.

Q: Why is it proving such a challenge to develop a vaccine against malaria?

SD: There are a number of reasons why it has proved so challenging; most of the vaccines that we have already are based on bacteria and viruses, and in the past they have proved relatively successful. Malaria is actually caused by a parasite called Plasmodium, and the parasite is a highly evolved and complex organism. It is also a master of disguise - it changes its appearance at each step of the infectious process in the body so that is one of the reasons why it has proved very challenging. I think one of the others is that the classical way of making a vaccine is to take the whole organism, the whole bacterium or the virus and to inactivate it and to inject that as your vaccine. That can be done for malaria, and we can do that experimentally, but it has been very hard to deploy that into a product - it is actually even hard to grow the parasites in the lab - so that has not been possible and it has actually been challenging for scientists to find other ways of inducing protective responses.

Q: Is there an Achilles heel in the malaria parasite?

SD: Achilles heels are really the holy grails of research; you could define them as a function of the parasite that is absolutely critical to its survival. They are traditionally quite hard to find, but it doesn't mean they are not there if you don't look hard enough. My group actually works on vaccines that try to kill the parasite in the blood, when the parasite is replicating in someone's blood stream and that is when they become sick. Very recently a pathway has been described that appears to be essential for the parasite to get inside a red blood cell, and what we have shown is that antibodies against that pathway can neutralise that process, and it neutralises all strains of malaria parasite. That is a very exciting result, it is very promising and would represent an Achilles heel so to speak.

Q: What is the next step now?

SD: Our group is very much focused on translational research, we aim to take our most promising candidates from the laboratory and into the clinic. What we will look to do now is manufacture that vaccine as clinical grade material, and then we will aim to do a series of proof of concept clinical trials. We will vaccinate healthy adult volunteers here in Oxford, and first of all we will look at the safety of the vaccine. After that we will look at the immune responses induced by that vaccine, and primarily the antibody responses, and if those are looking good and they appear to kill the parasite in our experiments in the laboratory we would then go on to see if the vaccine is actually efficacious and whether it could kill malaria parasites in the blood.

Q: What are the most important lines of research that have developed over the past five to ten years?

SD: There are always a lot of lines of exciting research. I think one of the most exciting has been the expansion in genetics and in genomics: in the last ten years the malaria parasite genome was published and that revealed the parasite has over five thousand different genes. Now all of those encode a different protein, and in the past only a small handful, maybe ten to fifteen have been tested as vaccine candidates, so there is certainly a lot of exciting work to come in the future testing all those new possible proteins that have come from the genome. I think one of the other exciting areas has been the improvement in vaccine technologies: the technologies that we have today are actually capable of inducing immune responses that are much stronger than anything we have seen in the past, and that is both for antibodies and T cell or our white blood cell responses, so that is all looking extremely promising in terms of future vaccine development.

Q: Why does your line of research matter, why should we put money into it?

SD: Why do I think it's important? I think there are a number of reasons! First of all malaria continues to exert a huge burden on global public health, it affects hundreds of millions of people every year and leads to the death of just under a million individuals, primarily children under the age of five years in the developing world, so I think we have a humanitarian obligation to try and do something about that. Also if you look throughout history vaccines have made a huge impact in terms of reducing the burden of infectious diseases and they are highly cost effective, so I think they are certainly very worthwhile developing. I think that maybe a final reason is that we are fairly fortunate in malaria, we know that you can induce immunity to the parasite, we can do that experimentally, and after many years of exposure in the field people become naturally immune, so we know it can be done it has just been a challenge to develop a vaccine in a vial that you can then use to vaccinate people. But just because something is difficult I don't think we should give up, I think it is very important that we keep trying.

Q: How does your research fit into translational medicine within the department?

SD: My group is within the Jenner Institute which is the vaccine department of the University. There we work on a wide range of difficult infectious diseases, and as a group we focus on the development of vaccines that induce antibody responses. A lot of the technologies and vaccine delivery platforms that we have developed are actually now being used against other viral and bacterial diseases, so I think it is important within the department that people can learn from what we have developed just as much as we can learn from what the other groups are doing. I think one of the other important aspects is that we are very much focused on translational research, we want to take our best vaccine candidates from the laboratory and into the clinic, and undertaking clinical trials of the most promising approaches is certainly a very important aspect of doing translational medicine.

Simon Draper

Malaria immunity

Professor Simon Draper’s research interests include studies of vaccine-induced malaria immunity. His group focuses on translational medicine: they will take their most promising vaccine candidates and manufacture them as clinical grade material. The next step is proof of concept clinical trials (Phase I and IIa) in healthy volunteers.

More podcasts related to Malaria

Bob Taylor: Primaquine for vivax and falciparum malaria

Primaquine can be used both to treat vivax malaria and to prevent the transmission of falciparum malaria from human to mosquito. A shorter and age-based primaquine regimen would reduce the burden of vivax malaria. It would also allow primaquine to be used more widely to block the transmission of falciparum malaria.

Lisa White: Mathematical modelling for tropical diseases

Mathematical modelling, particularly when combined with economical modelling, allows researchers and policy makers to determine the most effective interventions to fight infectious diseases such as malaria. We can use those models to explore ‘what ifs’ scenarios, at country or province level, save more lives and limit costs.

Ric Price: Curing Plasmodium vivax malaria

Vivax malaria used to be considered benign but is now recognised as an important cause of morbidity and mortality. Resistance to chloroquine (given to treat the parasite blood stage) is growing and ACT (artemisinin-based combination therapy) is becoming common treatment for vivax malaria. New drugs and better public health strategies can help elimination targets, anticipated for 2030.

Olivo Miotto: Genomics and global health

Genomics is the study of the complete DNA sequence, for example of a particular parasite, allowing us to analyse its evolution and the impact of human interventions. Alongside clinical date, we use genomics to identify mutations that are markers for drug resistance. Mapping out drug resistance then helps inform elimination programmes.

Frank Smithuis: Fighting malaria in Myanmar

Although malaria is decreasing in Myanmar, resistance to anti-malarials is on the rise in the region and the focus is now to treat people early, particularly in remote communities. MOCRU has set up a network of community health workers, trained and supplied with diagnostics, bednets and treatments, to help improve access to healthcare as well as produce the evidence to encourage policy changes.

Andrea Ruecker: Blocking malaria transmission

In the falciparum malaria parasite cycle, the gametocyte stages are responsible for the transmission from person to mosquito, then to other persons. A better understanding of how gametocytes respond to malaria treatments would help us block transmission and ultimately eliminate malaria.

Rob van der Pluijm: Tracking antimalarial resistance and treatment of malaria using Triple ACTs

Anti-malaria drug resistance is spreading throughout Southeast Asia and we need to find new treatments. Our researchers at MORU use a combination of artemisinin and two partner drugs instead of one. If confirmed safe and tolerable, triple artemisinin combination therapies might be a good option to treat multi-drug resistant malaria, as well as slow down the emergence and spread of anti-malarial resistance.

James Watson: Primaquine and vivax malaria

Primaquine is a drug used to eliminate vivax malaria from the liver and prevent relapses. However, it causes anaemia in patients with G6PD deficiency. A new, slightly longer regimen with increasing doses of primaquine could allow to safely treat all patients with vivax malaria.

Xin Hui Chan: Using big data to eliminate malaria

Malaria is the most important parasitic infection to still affect humans, and a safe use of antimalarial drugs is paramount. The current explosion of clinical data is causing a jungle of data; making sense of all this data will greatly help us in our fight to eliminate malaria.

Bob Snow: Malaria control in Africa

Quality data is vital to design better malaria control programmes. This project helps various African countries gather epidemiological evidence to better control malaria. Professor Bob Snow showed how sub-regional, evidence-based platforms can effectively change malaria treatment policies.

Translational Medicine

From Bench to Bedside

Ultimately, medical research must translate into improved treatments for patients. At the Nuffield Department of Medicine, our researchers collaborate to develop better health care, improved quality of life, and enhanced preventative measures for all patients. Our findings in the laboratory are translated into changes in clinical practice, from bench to bedside.