Malaria molecular surveillance

Malaria molecular surveillance (MMS) has considerable potential to be used widely as a programmatic decision-making tool. National malaria programs can use MMS to improve their understanding of factors driving transmission and guide selection and targeting of intervention strategies, yet there has been limited routine programmatic use of MMS to date. Outside of drug resistance and diagnostic target (histidine-rich protein deletions) monitoring, parasite genotyping for MMS has been implemented almost entirely within research settings. Scaling up MMS requires improved technical and programmatic capacity to routinely process, interpret, and use genomic data, as well as consensus around a broader evidence base for how MMS can be an effective and practical tool for programmatic decision-making. The MEI is addressing these gaps and supporting faster translation of MMS into programmatic use through a collaborative and program-driven approach that fosters capacity building and sustainable links between national malaria programs, research scientists, and regional networks.

Specifically, the MEI and a network of partners are generating evidence and building consensus and capacity on use cases for MMS in southern Africa using a discovery-oriented research approach guided by programmatic priorities and grounded in collaborative efforts to build sustainable in-country lab and analytic capacity. This approach will foster policy changes to accelerate uptake of parasite genotyping to inform program design, as well as create sustainable links between national malaria programs, regional science and public health networks, and the global research community.

The MEI is working to achieve these goals primarily through experiential capacity building and targeted projects with the Elimination 8 (E8), a coalition of eight countries working together to eliminate malaria in southern Africa. The MEI’s collaboration with the E8 is focused on: 1) joint learning through a fellowship program to build skills in translating MMS from the laboratory to a public health tool; and 2) specific use case research projects derived from country-level questions. Genotyping and analyses are being conducted with local Centers of Excellence in southern Africa, with technical assistance and capacity building provided by experts from leading international institutions.