Namita Joshi

Deputy Director for Policy and Communications

Division of Parasitic Diseases and Malaria

Center for Global Health

June 2015

CDC’s Malaria Program and Priorities

Division of Parasitic Diseases and Malaria

Center for Global Health

Division of Parasitic Diseases and Malaria

•Director: Laurence Slutsker

•Deputy Director for Management & Operations: Eric

Gogstad

•Deputy Director for Program & Science/ADS: Monica

•Parise

•Associate Director for Laboratory Science: Kumar

Udhayakumar

•Associate Director for Policy: Namita Joshi

•Data Management Activity: Ryan Wiegand

Office of the Director

Malaria Branch

•Chief: S. Patrick Kachur

•Manager: Richard Kahn

Parasitic Diseases Branch

•Chief: Stephanie Bialek

•Manager: Hoang Dang

Entomology Branch

•Chief: William Hawley

•Manager: Matthew Stockton

Strategic Applied

Science

Team Lead:

Mary Hamel

Program

Implementation

Team Lead:

Peter McElroy

Domestic

Response

Team Lead:

Paul Arguin

Laboratory

Research &

Development

Team Lead:

John Barnwell

Elimination & Control

Team Lead: Leanne Fox

Epidemiology

Team Lead: Susan Montgomery

Diagnostics & Biology

Team Lead: Vacant

Operations and Vector Genetics

Team Lead: Ellen Dotson

Field Support

Team Lead: John Gimnig

Chemistry & Resistance

Team Lead: Bill Brogdon

2

Malaria in the United States

Malaria vectors —

Anopheles mosquitoes —

are widespread in U.S.

CDC helps keep the U.S.

safe:

Advises public how to protect

themselves from malaria

during travel

Tracks malaria

Helps clinicians diagnose and

treat malaria cases 24/7

http://www.cdc.gov/mmwr/preview/mmwrhtml/ss6312a1.htm

3

President’s Malaria Initiative (PMI)Interagency initiative to reduce illness and death in

high-burden African countries

CDC supports PMI through:

Scaling up control interventions

Insecticide-treated nets

Indoor residual spraying

Confirmed diagnosis and treatment with

artemisinin combination therapy (ACT)

Preventive treatment for pregnant women

Scientific expertise

Strategic information (surveillance,

research and M&E)

Diagnosis and treatment

Prevention

Laboratory strengthening

4

PMI: Scaling up proven toolsRapid diagnosis and artemisinin-based

combination therapies (ACTs)

Insecticide-treated bed nets

(ITNs)

Intermittent preventive treatment in

pregnancy (IPTp)

Indoor residual spraying (IRS) (where

appropriate)

5

CDC contributed to the development and evaluation of four interventions now

used worldwide.

Malaria interventions save lives

Challenges to this success include:

Insecticide treated nets: coverage, durability, insecticide resistance, and

changes in mosquito behavior

Evidence of artemisinin drug resistance

TOMORROW

Intermittent screen and treat, mass drug administration, single

encounter radical cure treatments, transmission

blocking drugs, durable wall liners, spatial repellents, novel

diagnostics, vaccines

TODAY

Prevention Insecticide-treated bed

nets, indoor spraying,

preventive treatment

for pregnant women

and infants, seasonal

chemoprevention

TODAY

TreatmentDiagnosis with rapid

tests and combination

treatment, pre-referral

and definitive

treatment of severe

disease

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CDC Malaria Priorities

Malaria in the U.S.

(monitoring, diagnostics,

clinical guidance,

prevention)

Accelerate elimination

and control of malaria

Research

Elimination

Parasite, vector, case

management

What is the right mix?

7

Accelerate the Elimination of Malaria

New WHO Global Technical

Strategy calls for acceleration

towards elimination

Regional focus for assisting

countries to eliminate malaria

Hispaniola

South East Asia

5 PMI focus countries

New tools and approaches needed

to support elimination, such as

• strong disease monitoring

system

• diagnostic tools developed for

use in low transmission settings

8

CDC’s Scientific Investments in Malaria

Evaluation and impact of current

interventions

Routine surveillance, field evaluation of promising tools &

approaches, scientific leadership

Basic development of new drugs,

diagnostics, vector control paradigms,

vaccines

PMI CDC Applied Science BMGF, NIH

Prevention and Control Elimination/Eradication

9

10

Malaria Science at CDC

Donald Stokes (1997). Pasteur’s Quadrant: Basic science and Technological Innovation. Washington: Brookings Institution Press.

Basic Research

Pure Science

Bohr’s quadrant

Use-inspired Research

Strategic Science

Pasteur’s quadrant

Operations Research

Applied Science

Edison’s quadrant

low Immediate Use Potential highlow

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Adapting human parasites to laboratory models

Natural history of malaria infection in highly endemic settings

Systems effectiveness of artemisinin-based combination treatment

Efficacy of insecticide-treated nets, malaria vaccine candidates

Effect of intermittent screening and treatment on transmission

Identification of new diagnostic targets and approaches

Evaluation of spatial repellants for malaria prevention

Parenteral artesunate for severe malaria in North America (IND)

Durability of long-lasting insecticidal nets in field conditions

Impact evaluation after scale up of proven malaria control tools

Cost-effectiveness of universal diagnostic testing in African countries

Malaria Science at CDC: ExamplesPure Science

Applied Science

Strategic Science

Research to Support Elimination

Development of more sensitive diagnostic tests to help detect

persons with low density infections as a way to further reduce

transmission

Field trials of promising malaria vaccines: RTS,S/AS01 and PfSPZ

Evaluation of improved nets, new insecticides, novel vector

control paradigms: insecticide treated durable wall liners and

spatial repellants

Evaluating strategic use of antimalarial drugs administered to

target populations to reduce transmission and burden

CDC provides global resources through its Collaborating Centers,

world renowned insectary and laboratories

Research partnerships in the Greater Mekong subRegion, Latin

America, Indonesia, Kenya, Madagascar, Malawi, Tanzania, Uganda

12

Drug Quality/Counterfeit Drugs Robust sampling methodologies to assess presence of

counterfeits

Developing rapid field assays

Evaluation of FDA’s CD3 device and co-inventor of the CD4

Antimalarial drug analysis activites

multiple countries completing drug efficacy studies

Analysis for the Global Health Access Program , on the Thailand-

Burma border

Analysis of analyzed ACTs acquired by the Global Fund Joint

Inter-Agency Task Force (JIATF)

Cosponsored an antimalarial drug quality in Africa

symposium at the 6th Multilateral Initiative on Malaria

Pan-African Malaria Congress

13

Drugs/Diagnostics/Vector Control

New and existing malaria drugs for reducing

transmission

Examples: mass drug administration, mass screen and treat

Improved diagnostic tests capable of identifying low

levels of infection and transmission.

ReaLAMP

Multiplex format

New tools for vector control, including pesticides and

paradigms for deliver them

Wall liners, spatial repellants, baited traps

14

What More Can Be Done?

Surveillance as an

intervention

Moving diagnosis and

treatment beyond case

management

Development and

deployment of new tools

Mitigating threats to

continued progress

15

For more information please contact Centers for Disease Control and Prevention

1600 Clifton Road NE, Atlanta, GA 30333

Telephone, 1-800-CDC-INFO (232-4636)/TTY: 1-888-232-6348

E-mail: cdcinfo@cdc.gov Web: www.cdc.gov

Namita Joshi

ngs5@cdc.gov

www.cdc.gov/malaria

Center for Global Health

Malaria Branch, Division of Parasitic Diseases and Malaria

The findings and conclusions in this report are those of the authors and do not necessarily represent the official

position of the Centers for Disease Control and Prevention.