sponsors (IOM, 1996). The following three findings reached by the participants of the 1996 workshop are especially pertinent to this review: (1) malaria is still the most prevalent vector-borne disease in the world, (2) a malaria vaccine is feasible, and (3) the high cost of vaccine development dictates a coordinated strategy and a need to focus on a limited number of options (IOM, 1996).

The committee also reviewed the recent Malaria Vaccine Technology Roadmap (Roadmap, 2006), produced by a broad consensus process, with funding from the Bill and Melinda Gates Foundation and the Wellcome Trust. The Malaria Vaccine Technology Roadmap is a draft guide produced by the international community of researchers devoted to the development of an effective malaria vaccine. The roadmap identifies major barriers that need to be overcome in order to advance the development of an effective vaccine and recommends strategic priorities and approaches.

The timetable of meetings for the IOM study committee was as follows:

  • First meeting: January 23–25, 2006, at Silver Spring, Maryland

  • Teleconference: February 15, 2006

  • Second meeting: February 22–23, 2006, at Irvine, California

  • Teleconference: March 14, 2006

SCOPE AND ORGANIZATION OF THE REPORT

All four species of human malaria (P. falciparum, P. vivax, P. ovale, and P. malariae) present a threat. The potentially fatal P. falciparum is the most severe and important, although P. vivax causes debilitating disease and is common in many areas outside Africa. Vaccines can be developed from any of three possible stages of malaria—the preerythrocytic, blood, or transmission stages. This report focuses on the first two of these stages. The transmission stage type of vaccine is not a current active area of research in the MIDRP Malaria Vaccine Program. Although potentially effective in reducing transmission levels and hence new infections, this strategy is less useful for immediate individual protection on arrival in an endemic area. As requested by USAMRMC, the committee restricted its deliberations to P. falciparum malaria—the current focus of the MIDRP Malaria Vaccine Program—and to vaccines against the preerythrocytic and blood stages.

A list of recommendations is provided in Box S-1. The report is divided into five chapters and has nine appendixes. Chapter 1, the current chapter, is the Introduction, describing how this study came about, the charge to the committee, and the processes by which the committee went about its task. Chapter 2 describes the magnitude of the malaria problem in the world and the threat this presents to the military. Data on



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