Malaria parasites are developing resistance to the drugs that kill them, and researchers are now optimising a molecule that targets an essential parasite enzyme to create a new oral treatment. This matters because progress against malaria has stalled. In 2020, the disease caused 241 million cases and 627,000 deaths worldwide, with Africa bearing 95% of cases and 96% of deaths. Children under five account for 80% of all malaria deaths in Africa. Resistance to current frontline drugs is rising in Southeast Asia and Africa, and no new class of antimalarial has reached the clinic in decades. The research team has identified that the enzyme *Plasmodium falciparum* acetyl-CoA synthetase is essential for parasite survival. They have already developed a series of molecules, starting from a compound called MMV019721, that are more potent and can be dosed orally. This project aims to further optimise the molecule’s ability to kill the parasite, its stability in the body, and its safety profile. If successful, the project will deliver a late lead compound ready for advanced toxicological studies and, eventually, human clinical trials. A new oral antimalarial could treat and prevent infections, reduce deaths in children and other vulnerable groups, and ease the economic burden on endemic countries where malaria keeps children out of school and adults out of work.
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There were approximately 241 million cases of malaria and 627,000 deaths worldwide in 2020. Africa carries a disproportionally high share of the global malaria burden. In 2020, the African continent accounted for 95% of malaria cases and 96% of malaria deaths. Children under 5 years of age, pregnant women, patients with HIV/AIDS and people with low immunity moving to areas with high level of transmission are a higher risk of contracting malaria and developing severe disease. Among those, children under 5 years account for 80% of all malaria deaths in Africa. In addition, malaria has a negative impact in the economy of countries where is endemic, keeping children out of school and adults out or work, contributing the cycle of poverty and increasing pressure in fragile health systems. In the past five years the reduction in malaria incidence and mortality has stalled and resistance to the current standard of care is rising in southeast Asia and Africa. There is an urgent need for new antimalarial agents for treatment and prophylaxis. Our group, in collaboration with other members of the Malaria Drug Accelerator (MalDA), have recently demonstrated that the enzyme P. falciparum acetyl-CoA synthetase is essential for the survival of malaria parasites. We identified two molecules that interfere with the function of this enzyme and have the potential to be developed into new medicines for the treatment and prevention of malaria infections. However, these two molecules are not sufficiently potent and do not have the properties required for an oral drug. We selected for optimisation one of these molecules, MMV019721. We have now developed more potent molecules with improved properties that can be dosed orally, and we are confident of the potential for further optimisation towards a new treatment for malaria. The aim of this proposal is to improve the properties of this class of molecules to deliver a declared late lead according to the Medicines for Malaria Venture (MMV) Late Lead Criteria. This will require us to optimise multiple features of the molecule including its ability to kill the malaria parasite, its ability to reach the site of the body where the parasite resides without being broken down and its safety. At the end of the project the late lead will be ready to enter more advance toxicological studies before moving into human clinical trials.
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