Switzerland-based Novartis released results of what it called a next-generation treatment: a study of its experimental drug in 12 African countries found it works well against the mosquito-borne parasite that causes malaria and seems to block spread.

The drug, called GanLum, is not yet licensed and is more than a year away from being available. But it is needed, said Dr David Sullivan, a malaria expert at Johns Hopkins University.

The parasite that causes the disease is developing resistance to existing drugs, meaning “the ice is thinning”, Sullivan cautioned, adding: “It hasn’t given way, but we’re concerned.”

GanLum is a combination of a new drug known as ganaplacide, and an existing long-acting medication, lumefantrine. It is given as a packet of tiny powder-like granules, once daily for three days.

But getting people to take malaria drugs over several days has been challenging – some stop after feeling better from just one or two doses.

Experts say a third or more of malaria patients fail to complete the current standard three-day treatment course, a problem that can encourage drug resistance and allow curable cases to intensify.

In an effort to offer a one-time treatment, another team of researchers said an experiment in West Africa found that a single dose of four widely available malaria drugs proved to be an effective cure.

The two studies were presented on Wednesday at the American Society of Tropical Medicine and Hygiene conference in Toronto, Canada.

Malaria is caused by a parasite that spreads through mosquito bites. Infected people can suffer fever, chills and flu-like illness that, left untreated, can lead to severe complications and death.

The medical battle against malaria has ebbed and flowed as new drugs come along, but the parasite gradually develops the ability to resist them.

At the beginning of this century, for example, resistance to the drug chloroquine was widespread, and malaria killed more than 1.8 million people per year. But then came a class of drugs known as artemisinins, which worked well and helped drive a dramatic decline in global malaria death rates.

Artemisinin-based compounds remain the first-line treatment in most cases. But signs of partial resistance have been reported, and – for several reasons – malaria death rates have plateaued or even started to rise in some parts of the world.

Dr Ghyslain Mombo-Ngoma led a study in Gabon in which researchers gave a single-dose treatment combining an artemisinin with three other antimalarial medications: pyronaridine, sulfadoxine, and pyrimethamine.

From May 2024 to last month, he and his colleagues treated more than 1,000 patients, half of them younger than age 10, who were sick with malaria but not suffering life-threatening symptoms. A little over half got the four-drug, one-time treatment. The rest got a standard, artemisinin-based treatment.

Blood tests 28 days later showed 93% of patients who received the one-time treatment were free of parasites, compared with 90% who received the standard three-day course.

Mombo-Ngoma said there are discussions underway with a drug manufacturer to produce a single capsule or packet of pills to help create an inexpensive, easy-to-take cure.

Sullivan, however, noted that resistance is already established to some components of the treatment, meaning it likely will prove to be “a short-term fix”.

GanLum’s potential

In a study involving about 1,700 adults and children in 12 African countries, Novartis’s GanLum was found to have a cure rate of better than 97%, which was a little higher than a common artemisinin-based treatment.

It was also highly effective against mutant malaria parasites with partial drug resistance, Novartis officials said.

Side effects included fever and anaemia, similar to what’s seen in patients who take some of the current antimalarials, officials added. There was a higher level of vomiting right after the drug was given, which company officials say may stem from its taste. The company is therefore exploring flavouring or sweetening.

Novartis officials further said they are working towards regulatory approvals, and hope to see GanLum rolling out to patients within 18 months.

The new treatment approaches can complement other efforts against malaria, including treated mosquito bed nets and new vaccines, said Dr Andrea Bosman, a malaria expert with the World Health Organization.

But the promising news comes at a time when funding from the United States and other sources is being cut, which could impact the ability of scientists to monitor drug resistance or make prevention and treatments available to people who need them, Bosman noted.