Improving the treatment of tropical infectious diseases

In the final three years of my Principle Fellowship I wish to complete studies to improve the treatment and elimination of malaria. To counter the threat of antimalarial drug resistance emerging from the Greater Mekong sub-region I have recommended a switch to triple artemisinin combination treatments and developed the methods to conduct targeted malaria elimination in endemic areas. I propose a series of studies to assess the safety, efficacy and overall benefit of these new approaches. To support control and elimination I will develop and evaluate better methods of identifying, measuring and monitoring antimalarial drug resistance. To prevent relapses of vivax malaria (the main therapeutic challenge and obstacle to elimination) I will investigate safer methods of giving primaquine, and identify the optimum dose of tafenoquine. I will improve methods for the pharmacometric assessment of antimalarial drugs and I will apply similar proven principles to the assessment of much needed treatments of Chagas disease and COVID-19. I will develop a pharmacometric platform based on assessment of parasite and virus clearance rates respectively for assessing and comparing new drug treatments. This is necessary to inform the choice of drug and dose in larger phase 3 assessments, accelerating their development.