MalariaX: Defeating Malaria from the Genes to the Globe

Module 1: Setting the Stage for Malaria Elimination

The course begins with the "big picture." In the lecture, Dr. Pedro L. Alonso, the head of the World Health Organization (WHO) Global Malaria Programme, offers an overview of the progress made—as well as challenges encountered – in malaria control and towards malaria elimination over the past decade. The module contextualizes these trends in WHO’s ongoing transition from promoting a "one-size-fits-all" strategy to tailoring and targeting interventions according to local and regional epidemiological, environmental, and political contexts.

This module provides foundational scientific knowledge for the course, including important biological aspects of the malaria parasite, the mosquito vector, and the human host. In this module’s lecture, Professor Dyann F. Wirth begins with a brief overview of how malaria came to be understood, then goes into detail on the parasite’s life cycle, how malaria affects humans, and the existing and sought-after tools to prevent and treat malaria. Finally, Professor Wirth reviews global endeavors to eradicate malaria.

In this module, Professor Manoj Duraisingh offers a deeper look at Plasmodium vivax , the most geographically widespread malaria parasite, and compares the biological differences between Plasmodium falciparum and Plasmodium vivax. Professor Duraisingh will offer insights on current gaps in Plasmodium vivax biology, ecology, and epidemiology. Learners will gain insights on the difficulties in controlling Plasmodium vivax and possible solutions for the elimination of the parasite.

This module focuses on the Anopheles mosquitoes, which are the vectors that transmit malaria from human to human. Professor Flaminia Catteruccia discusses biological and anatomical features of mosquitoes that influence how the parasite is acquired from humans, develops in the mosquito, and is transmitted back to humans. Professor Catteruccia then discusses how current vector control strategies work, why they fail, and how an improved understanding of vector biology can lead to improved vector and parasite control strategies.

In this module, the course delves deeper into the malaria transmission cycle, including how it can be interrupted. Professor Matthias Marti examines the cycle of malaria parasite transmission between humans and mosquitoes, including mechanisms of parasite sequestration in the human body, and the life cycle of the parasite in the mosquito. The module then applies these concepts to examine the dynamics of infectiousness and transmission. Finally, natural transmission-blocking mechanisms are considered in the context of the ongoing development of vaccines against malaria.

This course module introduces learners to the contributions of the burgeoning field of genomics to understanding and controlling malaria. After introducing key genetic principles, Dr. Sarah Volkman uses data on genetics from Senegal, Panama, and Mozambique to describe how parasite populations are changing. Currently available genomic tools and methods, along with their application to inform key questions about malaria transmission, prevention, and treatment, are discussed.

In this module, the course’s focus shifts from the microscopic genes to a more global perspective. Using a systemic view of malaria, the module describes human and environmental factors that influence how malaria is manifested and how control efforts work. Professor Marcia Castro discusses various components of global "systems" that enable the continued existence of malaria, and presents historical examples that exemplify the importance of these components. Professor Castro also describes the challenges and the opportunities in the struggle to eradicate malaria that these human and environmental factors create.

In this module, the course presents another analytical approach that has been repeatedly shown to be necessary for successful malaria programming, as well as for public health more broadly. Professor Michael R. Reich approaches the topic of malaria control and eradication policy from the realm of politics. This module provides overviews of principles of applied political analysis and analysis methods that can be used to promote appropriate policy reforms. Professor Reich walks through the use of PolicyMaker, a free open-source political analysis software, analyzing case studies including one on the Affordable Medicines for Malaria Facility (AMFm).

This module discusses disease surveillance, a health system function essential to malaria elimination. Surveillance—finding where and when transmission of infectious diseases takes place—is critical for deciding where to target public health actions. In the lecture, Professor Marcel Tanner provides an in-depth examination of how to use monitoring and evaluation (M&E), surveillance-response, and data analysis effectively for malaria control and elimination. Using case studies from Zambia, China, the Pacific Islands and Tanzania, the module provides practical guidance on developing surveillance-response approaches and discusses how surveillance systems can be incorporated into public health programs.

In this module, Dr. Abdisalan Noor focuses on the analysis and use of malaria-related data to inform national and subnational strategic plans for malaria elimination, intervention targeting, and prioritization of resources. Learners will be introduced to concepts and metrics for malaria stratification, including the strengths and weaknesses of commonly used metrics for stratification. Dr. Noor discusses how stratification for elimination allows for focused, tailored responses by assigning specific intervention packages and deploying strategies to designated areas.