Credit: : Alfred Amambua Ngwa
I come from Cameroon, which sees six million malaria cases annually and which this year became the first country to roll out a free, routine malaria vaccine programme. My path as a malaria researcher began 20 years ago after I completed a PhD in Biochemistry at the University of Buea on the immunopathology of blinding parasitic infections caused by the Onchocerca volvulus worm.
During my postgraduate research training I travelled to many villages in Cameroon and noticed that some people responded differently to malaria parasite infections compared to family and friends back home. Some became only mildly sick or remained asymptomatic, while others died. I was intrigued. Was this due to the formidable malaria pathogen, the environment or because of differences between people?
One of my first malaria-related assignments was to search for protective candidate antigens to use in vaccines. I soon learned how the genetic diversity of malaria parasites stood in the way of a long-lasting and widely efficacious vaccine.
Since 2006 I have worked in The Gambia, a small West African country where malaria cases dropped by 70% between 2011 and 2022. I am a professor in the Disease Control and Elimination Department of the Medical Research Council Unit in The Gambia, under the London School of Hygiene and Tropical Medicine at the Fajara campus in the coastal town of Banjul.
We have excellent laboratory and research facilities available. My team collaborates with the Wellcome Sanger Institute in the United Kingdom, and the Human Hereditary and Health in Africa’s (H3Africa) Pan-African Malaria Genetic Epidemiology Network (PAMGEN) consortium. During the malaria season, between July and January, I visit our research sites in The Gambia and other West African countries, to discuss progress with students, collaborators, communities and public health officials.
We translate genomic surveillance of malaria parasites and vectors to help national malaria control programs plan interventions better. Insights from my more than 100 papers (among others in Science and Nature Microbiology) help track the spread of drug-resistant parasites and insecticide-resistant mosquito populations.
We now have some answers to the question I posed all those years ago in Cameroon - why some people suffer worse effects of malaria than others. One answer is that specific mechanisms in the biology of malaria-related parasites enable resistance to vaccine and drug interventions. It is also influenced by the genomic diversity of humans and mosquito vectors across Africa.
