From control to eradication of malaria: the end of being stuck in second gear?

ObjectiveMore than 2 billion people are at risk of malaria, which primarily affects poor populations in tropical and subtropical areas, including Southern Asia. As malaria incidence has been reduced strongly in some parts of endemic regions by combinations of interventions, including artemisinin-based therapies and insecticide-treated bed nets, a new goal has been established recently by charity foundations which support research on malaria: the worldwide eradication of the pathology. Doing away with control approaches which have been applied for the last 50 years and more focus on elimination objectives will deeply change priorities in the area of malaria treatment, chemoprevention, vector control, vaccine research and health system assessment. In this review, actual knowledge on pathogenesis and pharmacology is discussed, and new drugs, vaccines and insecticides are described.