Discovering new transmission-blocking antimalarial compounds : challenges and opportunities

Abstract

The ability to target human-mosquito parasite transmission challenges global malaria elimination. However, it is not obvious what a transmission-blocking drug will look like; should it 1) target only parasite transmission stages; 2) be combined with a partner drug killing the pathogenic asexual stages or 3) kill both the sexual and asexual blood stages, preferably displaying polypharmacology. The development of transmission-blocking anti-malarials requires objective analyses of the current strategies. Here, pertinent issues and unanswered questions regarding the target candidate profile of a transmission-blocking compound, and its role in malaria elimination strategies are highlighted and novel perspectives proposed. The essential role of a test cascade that integrates screening and validation strategies to identify next generation transmission-blocking anti-malarials is emphasised.