Approaches to malaria vaccine development using the retrospectroscope

Abstract

The start of the first phase III trial of a malaria vaccine in 2009 marks a significant advance in malaria control. However, the goal of a vaccine with at least 80% efficacy lasting 4 or more years continues to be elusive. To reiterate Thomson's statement in 1933, ". . . it is necessary to stress the fact that there are many unsolved problems of great importance. It is not too much to state that if the mechanism of immunity in malaria were entirely solved the control of the disease and its treatment would be nearer accomplishment." Creative approaches are needed to better define the mechanisms of immunity that contribute to and inhibit protection against human malaria. Given the limitations imposed by the species specificities of host-parasite interactions, direct evaluation of the protective human immune response is paramount. Equally important to the development of active immunization strategies that effectively generate a protective response in humans by reproducing the protective response acquired through repeated natural infections or through novel mechanisms that do not occur in nature is the development of new experimental medicine approaches that safely permit elucidation of protective immune responses in humans, including passive immunization. In the end, it is highly likely that a multiantigen and multistage approach will be required to achieve the desired goal for malaria vaccines and should be planned accordingly. Copyright © 2009, American Society for Microbiology. All Rights Reserved.