An international nonprofit organization is trying to convince the U.S.
Agency for International Development (USAID) and Congress to boost
funding for drug research and development to combat malaria.

The Switzerland-based Medicines for Malaria Venture (MMV), which is managing one of the largest portfolios of anti-malarial projects worldwide, wants the U.S. government to ramp up funding for research and development from about $1.6 million a year to $10 million annually, for at least four years.

{mosads}The group notes that 250 million people suffer each year from malaria and nearly 1 million die annually from the disease. The mosquito-borne parasite is the third-deadliest infectious disease in the world, after HIV/AIDS and tuberculosis. More than 80 percent of deaths from malaria are among children under the age of 5 in Africa. The global health community has been fighting to eliminate the increasingly resistant parasite for years.

But MMV, a public-private product development partnership, could face an uphill battle. It is asking USAID and Congress to redirect more money beginning next year to drug research and development from a pot of funds used to cover the range of efforts to treat and prevent malaria, such as providing mosquito nets.

“One of the bigger challenges — a perpetual challenge — is that we do research and development, and it is easier to tell people of [things] which are here and now than things that are in the future,” Chris Hentschel, the CEO of MMV, said in an interview. “We are trying to make that which is still aspirational a reality.”

Hentschel, who lives in Geneva, recently made the rounds on Capitol Hill to promote his organization’s work and raise awareness of the risk of funding lapses for new drug developments. MMV also hired one of D.C.’s top lobbying shops, Van Scoyoc Associates, to represent its interests in Washington.

“The issue for us is to keep the pipeline going and to keep the products, which are in development, funded so that they see the light of day,” said Hentschel. “It’s easier to have this discussion when you can demonstrably show that it works.”

The MMV CEO came armed with one of the venture’s success stories: Coartem Dispersible, a cherry-flavored pediatric anti-malarial medicine, which can be dispersed in a small amount of water. The drug is easier to give to babies and children and it ensures that the proper dosage is taken to cure the malaria, he said.

Coartem Dispersible was developed by MMV and Novartis, a large pharmaceutical company. MMV estimates CoartemD to be 97.8 percent effective.

Hentschel said the new medicine masks the bitter taste of active ingredients with cherry flavoring. Previously, healthcare workers and parents had to crush bitter-tasting anti-malarial tablets so children could swallow the medicine.

The partnership between MMV and Novartis to develop the medicine shows how public-private partnerships have become one of the preferred ways of addressing healthcare issues that neither the public nor the private sector can solve alone.

“The combination of the pharmaceutical industry, with its knowledge and experience in drug discovery and development, and the public sector, with its expertise in basic biology, clinical medicine, field experience and above all its public remit, constitutes the rationale for MMV,” said Tony Kalm, MMV’s executive vice president for corporate development, in congressional testimony earlier this year.

While more than 9 million treatments of Coartem have been delivered this year, the fear among global health organizations is that drug-resistant strains of malaria have started to be reported, particularly at the Thai-Cambodian border. That means drugs such as Coartem, made with artemisinin (a compound isolated from the Chinese herb Artemisia annua), could be rendered useless and new drugs will have to be developed. MMV has more than two dozen projects in the pipeline.

 “The renewed emphasis on eradication has encouraged MMV to take a new direction,” Kalm said. “The portfolio today includes not only projects that show promise against the dangerous Plasmodium falciparum malaria, which is decimating the African continent, but those that will treat the rarer Plasmodium vivax malaria, tackle emerging resistance and stop transmission of infection. A choice of different malaria medications will be crucial if the long-term goal of eradication is to be achieved.”

The late Sen. Edward Kennedy (D-Mass.) was supportive of MMV’s efforts. He wrote to retired Rear Adm. Tim Ziemer, the coordinator of the President’s Malaria Initiative, at the end of July, requesting an increase of USAID funding.

“The venture is currently managing the largest portfolio of anti-malarial projects in history and is working with over 100 pharmaceutical, academic, nonprofit and endemic-country partners in 38 countries,” Kennedy wrote at the time.

Massachusetts also contributes to the development of anti-malarial projects with research and universities such as Harvard and MIT and pharmaceutical companies such as Genzyme and Paratek Pharmaceuticals.

Sen. Paul Kirk (D-Mass.), who was appointed to Kennedy’s seat until a special election in January, renewed the call to Ziemer in mid-November to increase USAID funding. Kirk said that MMV’s “core objective” is to “meet the anti-malarial medicine needs of the global community in a safe and expeditious manner.”

Kirk also pointed out that the report of the Senate State and Foreign Operations appropriations bill for 2010 encourages USAID to increase its investment in public-private partnerships involved in the research, development, access and delivery of anti-malarial medication.

The House version of the bill has similar language referring to public-private partnerships to combat infectious diseases, including malaria. Both Senate and House appropriations bills approved $585 million for all malaria-related efforts, including money to buy bed nets and drug treatment.

The largest donor to MMV by far is the Bill and Melinda Gates Foundation, at 67.3 percent of donations since 2000, followed by the United Kingdom Department of International Development with 11.8 percent. USAID is next with 3.4 percent, but Hentschel said he would like to see that go up close to the U.K. level.