Each year, millions of people are affected by malaria, a mosquito-borne disease caused by a parasite. The Military Malaria Research Program (MMRP) at Walter Reed Army Institute of Research (WRAIR) is powering through the never-ending quest for the most effect and up-to-date anti-malaria prevention measures.

Army Lt. Col. Mark Hickman, director of the program’s Experimental Therapeutics Branch at WRAIR in Silver Spring, Maryland, said the mission of the program is to come up with new medical countermeasures – including  vaccines and new drugs - to protect soldiers from the disease. A person infected with malaria can experience flu-like illness, including fever and chills. However, if malaria goes untreated, the risk of complications and death increases.

“Malaria is the number one infectious disease threat for the deployed American soldier and it’s been that way for decades,” said Hickman. About 1,500 people are diagnosed with malaria in the United States each year – most of them travelers to malaria-prone countries. Although the disease is not a threat in the U.S., it is a real danger in some parts of the world where service members are deployed. “[W]e have an ongoing program to develop new countermeasures due to, in particular, development of malaria drug resistance.”

As the year comes to an end, the program has completed studies on two malaria vaccines, for which clinical trials will begin in 2017. In addition, a novel antimalarial drug class developed at Walter Reed will also enter clinical trials next year.

Army Lt. Col. Norman Waters, director of the Military Malaria Research Program at WRAIR, said that having three products in clinical trials at the same time is essential as they try to stay ahead of drug resistance and other challenges, such as vaccine efficacy.

“Malaria drug resistance is never a question of if the malaria parasite will become drug resistant, it’s really a question of when,” said Waters. “We know that the parasites evolve very quickly and malaria drug resistance [can develop] in as little as a year sometimes.”

The vaccines developed by Walter Reed have achieved an efficacy rate of 80 percent in controlled human malaria infection clinical trials conducted at WRAIR. However, maintaining that efficacy throughout the service member’s deployment, which can be up to a year, is a challenge. Roughly 100 soldiers a year are infected with malaria and most of them are deployed to southwest Asia, said Hickman.

“Anyone who is exposed to malaria-infected mosquitos, particularly those who come from Western countries where they have no partial immunity to the malaria parasite, are at risk,” said Hickman. Unlike many other organizations researching preventive measures for malaria, MMRP focuses on prevention of disease for adults only. “Certainly our deployed soldiers, if they’re in that endemic area, are going to be at risk for getting malaria.”

With research institutions in Kenya and Thailand, an international collaboration for research has significantly helped the program’s advancements. Hickman called these areas the “crown jewels” of the Walter Reed Army Institute of Research in many ways as they provide a place for investigation where malaria is prevalent.

The U.S. Army has been actively studying and producing anti-malaria products since World War II. Drug resistance to those original drugs became rampant in southeast Asia in the 1960s, which prompted new drug development sponsored by the U.S. Army, said Hickman.

“[We] provide a product to protect the warfighter so the warfighter can do his mission. That’s our bottom line.”