Non-human primate models and in vitro liver stage cultures as alternatives in malaria drug development

Non-human primates (NHP) have been used extensively in the identification of new antimalarial compounds. Especially the Plasmodium cynomolgi/rhesus monkey model was a very popular substitute to evaluate compounds for P. vivax liver- and blood stages. Nowadays we have replaced, as much as possible, the NHP in vivo testing with in vitro assays. In this review, an overview is given on malaria drug testing in NHP, the development of the in vitro models and especially the in vitro hypnozoite assay, in which compounds can be tested for activity against dormant liver stage parasites. Benefits and limitations of this model will be discussed.