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Tracking antimalarial resistance in a rapidly changing landscape
There has been significant progress in malaria control toward elimination in recent years. Continued improvement will require optimal use and integration of all available approaches: vector control, prevention of infection, prompt diagnosis, and effective treatment of all who carry malaria parasites. These disparate operational activities require a common element: high quality, comprehensive information, analyzed in real time and made freely available to decision-makers. Antimalarial drug resistance compromises treatment efficacy, one key component of these required interventions.
To respond to this challenge, the WorldWide Antimalarial Resistance Network (WWARN) has established an international network of malaria researchers to provide intelligence on current antimalarial drug efficacy linking clinical, molecular, pharmacological, and in vitro methods. A secure platform transforms uploaded records of individual patient or parasite isolates into a standardized format and facilitates comparison and pooled analysis of the resulting very large datasets. There are many spatial gaps in the available datasets, and innovative tools have been developed to target surveillance and facilitate modeling of predicted temporal and geospatial trends in efficacy. Collaborative studies of these datasets now have sufficient power to identify and answer key public health questions. The community model used by WWARN demonstrates effective approaches for improving quality of data, encouraging data sharing and analysis by individual researchers and collaborative groups, and supports active use of the results by the malaria community.
Carol Hopkins Sibley is a Professor in the Department of Genome Sciences at the University of Washington in Seattle, where her early work focused on immunology. More than a decade ago, a sabbatical year spent at the Institute of Molecular Medicine in Oxford piqued her interest in antimalarial drug resistance – a focus of her research ever since. An active member of the international research community, Sibley has held positions at Seattle Biomedical Research Institute; the Nuffield Department of Medicine, University of Oxford, UK; the Walter Reed Army Institute for Research; and she has maintained close collaborations with colleagues in the KEMRI/Wellcome Trust Research Laboratories in Nairobi and Kilifi, Kenya. She is currently the Scientific Director of WWARN, which is funded by the Bill & Melinda Gates Foundation. Sibley serves on the Expert Scientific Advisory Board of the Medicines for Malaria Venture (MMV) and the Boards of the ACT Consortium, the Malaria Capacity Development Consortium, and several of the NIH-funded International Centers of Excellence in Malaria Research. Her research has focused on the genetics of Plasmodium falciparum, P. vivax, and Mycobacterium tuberculosis, and in recent years, the application of genetics to the management of drug resistance. She holds a BA and MS in Biology from the University of Rochester, a PhD in Biochemistry and Biophysics from the University of California, San Francisco, and completed postdoctoral training at Caltech.