New medicines to improve control and contribute to the eradication of malaria

Currently available medicines against Plasmodium falciparum are largely fixed-dose artemisinin-based combination therapies; the combination serves to protect individual medicines against resistance. For Plasmodium vivax radical cure, the standard of care is still primaquine, with no major breakthroughs in the past 60 years.New medicines that block transmission and dormant reservoirs of malaria parasite, such as the hypnozoite of P. vivax, will have an important role in the eradication of malaria.Next-generation therapies after artemisinin include new synthetic endoperoxides. With the emergence of artemisinin resistance, it is important to confirm that these medicines will have activity against artemisinin-resistant strains.New targets can come from an increase in our understanding of the parasite genome. More recently, screens against the whole parasite have also been successful. Screens against some pathways, such as purine and pyramidine metabolism, and mitochondrial electron transport, have produced interesting chemical series.Laying out what a new medicine has to achieve to be successful (that is, determining the target product profile) is an important and often underestimated step in drug discovery and development. A key factor in antimalarial medicines is to ensure safety, especially as they are administered in countries where adverse-event reporting is often limited.Over the past 10 years, there has been a change in the way medicines for malaria are discovered and developed. Increased interest from the pharmaceutical industry and charitable foundations has supported the work of the public–private partnerships in bringing forward a portfolio of new medicines, which will support the eradication agenda.