malaria

Can monoclonal antibodies save us from malaria morbidity and mortality? 

(Last Updated On: 22 August 2023)

Gulu I In Uganda, malaria is endemic in approximately 95% of the country, affecting over 90% of the population with over 20% of all hospital deaths.

Malaria is the leading cause of morbidity and mortality in many developing countries, where young children and pregnant women are the groups most affected.

Insecticide-treated bed nets (ITNs), indoor residual spraying (IRS) and artemisinin-based combination therapies (ACTs) are the first-line tools used for malaria control.

The effectiveness of these approaches is fast declining, prompting scientists and other practitioners to explore new malaria intervention tools and strategies. One such tool is the use of monoclonal antibodies to prevent the disease.

According to Jimmy Opigo, the Assistant Commissioner in charge of the National Malaria Control Division at the Ministry of Health, Uganda has continued to record an upsurge of malaria cases, especially in Acholi, Karamoja, and Bukedea sub-regions despite different government interventions to contain the disease.

Intervention

The development of monoclonal antibodies has revolutionized the treatment of many diseases and holds potential for future therapies.

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Monoclonal antibodies are lab-made molecules that mimic the immune system’s ability to fight off harmful pathogens. They are designed to target specific proteins in cells and can block the cell’s function or mark it for destruction.

They can be produced in large quantities in vitro and administered by injection or infusion. Monoclonal antibodies are used to treat various diseases, including cancer, autoimmune disorders, and infectious diseases like COVID-19.

Malaria is caused by a parasite transmitted by mosquitoes, and monoclonal antibodies can target specific proteins (epitopes) on the parasite’s surface, disrupting its ability to infect and replicate in body cells.

According to physicians, this is a promising area of research in the fight against malaria because monoclonal antibodies which are currently being explored for malaria prevention have proven promising results in its clinical trials.

“Clinical trials have shown that monoclonal antibodies can provide significant protection against malaria infection in humans, even at low doses, and have the potential for long-lasting protection,” he noted.

Further research is ongoing to develop effective antibody-based interventions for disease intervention in high-risk populations.

“For countries to promote research and production of monoclonal antibodies, they need to have regulations in place to ensure that the antibodies are safe and effective,” Dr Opigo added.

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Experts further reveal that there is also a need to provide funding and create an environment where scientists have the resources to work on this kind of research. Countries need to have skilled scientists and laboratory facilities to support the research and manufacturing of monoclonal antibodies.

Partnerships between different organizations and industries can help create the conditions needed to promote research into monoclonal antibodies and overall, it will take a collaborative effort between government, industry and academia to promote monoclonal antibody research and production.

Guidelines that can support the development and use of monoclonal antibodies for malaria prevention

There are global, regional and national guides on monoclonal antibodies that can support their development and use for malaria prevention effectively according to a clinical epidemiologist.

Several global, regional, and national organizations have developed guidelines to support the development and use of monoclonal antibodies for malaria prevention.

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These organizations include the World Health Organization (WHO), the Malaria Vaccine Technology Roadmap, the Roll Back Malaria Partnership, research organizations and academic institutions.

These guidelines provide recommendations on the development, testing, and deployment of monoclonal antibodies for malaria, ensuring their safe and effective use.

As monoclonal antibodies for malaria prevention is a relatively new and evolving field, the national guidelines in Uganda may require significant revisions to address challenges related to their development.

The challenges include limited financial resources, inadequate expertise, poor infrastructure, insufficient regulatory controls and once developed lack of access to monoclonal antibodies by those that need them the most. These challenges must be addressed to ensure the safe and effective use of monoclonal antibodies for malaria prevention in Uganda.

Are monoclonal antibodies a game-changer?

In an interview, Dr Bruce Kirenga, a researcher and executive director at the Makerere University Lung Institute says they have already been approached by two pharmaceutical companies offering them manufactured antibodies to use while conducting trials.

Kirenga says Uganda is lagging as many countries have already explored possibilities of having this treatment added to their plans.

Monoclonal antibodies have demonstrated their potential in treating and preventing various diseases, making them a promising technology for malaria prevention and treatment.

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