Despite major progress in efforts to eliminate or control malaria, the disease remains a significant global health challenge. According to the World Health Organisation‘s 2024 malaria report, the number of malaria cases worldwide actually rose above pre-COVID-19 pandemic levels from 2019. Each year, malaria continues to claim over 600,000 lives—most of them children under the age of five.
A growing challenge in the fight against malaria is the development of resistance against antimalarial drugs to treat the disease. Malaria parasites in the Greater Mekong Subregion (which includes countries in Southeast Asia) have developed resistance to artemisinin—the key component in current first-line treatments—and its partner drugs, piperaquine and mefloquine. This resistance first emerged over fifteen years ago in Cambodia and has now spread to all countries in the GMS threatening malaria elimination efforts in the Asia-Pacific region.
In her earlier PhD research, Dr Jasmin Akter used pre-clinical models to investigate how the immune system responds to malaria. She found that clearing infected red blood cells (pRBC clearance) is not the primary way naturally acquired antibodies control the disease. Instead, affinity-matured IgG antibodies appear to protect by binding to the malaria parasite—either to free-floating merozoites or fragments of ruptured cells—triggering immune responses from splenic macrophages and dendritic cells. These insights improve our understanding of natural and vaccine-induced immunity to malaria and may help inform future vaccine and treatment strategies. This foundational research training paved the way for Dr Akter’s current research interest to contribute to malaria elimination progress in her home country of Bangladesh.
Understanding the challenges and gaps to malaria elimination in Bangladesh
Between 2010 and 2018, Bangladesh made significant progress in the fight against malaria, reducing cases by 80%. In 2019, the country reported just over 17,000 confirmed cases. Most of these were caused by the Plasmodium falciparum parasite, with a smaller number due to P. vivax. Over 90% of all malaria cases occur in the Chittagong Hill Tract (CHT) districts, a region bordering Myanmar, which has a high burden of malaria and antimalarial resistant strains.
Bangladesh currently uses Artemisinin-based Combination Therapies (ACTs), including artemether-lumefantrine, as the main treatment for uncomplicated malaria. However, growing resistance to these drugs in nearby regions like the Thailand-Cambodia border is a concern, highlighting the need for careful parasite and treatment surveillance in Bangladesh.
Globally, more countries are moving toward malaria elimination, defined as fewer than 1,000 cases per year. But if control efforts slip or drug-resistant parasites increase, malaria could quickly return and cause serious morbidity and mortality. To prevent this, stronger surveillance systems—especially those using modern tools like molecular and genetic testing—are needed. These can help track how the parasite is changing and support the goal of eliminating malaria in 35 countries, including Bangladesh, by 2030.
What motivated you to pursue malaria research?
Despite decades of research, malaria remains a major global public health challenge. It is a complex disease, requiring multiple hosts to complete the parasite’s life cycle. The outcome of infection is influenced by dynamic interactions between the parasite and the human immune system.
Dr Akter says, “During my PhD, my research focused on understanding how the body controls the malaria parasite during the blood stage of infection. As someone from a malaria-endemic country, I am committed to using my knowledge and expertise to support efforts to eliminate malaria in Bangladesh.”
Contributing to the global fight against malaria
Dr Jasmin Akter, Assistant Scientist at icddr,b and a Research Fellow at the Centre for Innovation in Infectious Disease and Immunology Research (CIIDIR), Deakin University, Australia, is leading a study titled “Establishing Malaria Genomic Surveillance for Early Warning of Antimalarial Drug Resistance in the Chittagong Hill Tracts (CHT), Bangladesh.” The project aims to combat the emerging threat of resistance to Artemisinin-based Combination Therapies (ACTs), which are the frontline treatment for uncomplicated malaria in Bangladesh.
Funded by the Wellcome Trust (UK), the project is being carried out in collaboration with the National Malaria Elimination Program (NMEP) Bangladesh, BRAC, Deakin University (Australia), the Wellcome Sanger Institute (UK), and the Mahidol-Oxford Research Unit (Thailand). Fieldwork has already begun in the CHT region, with a focus on mapping current patterns of antimalarial drug resistance and understanding the genetic structure of local parasite populations. The data will support the development of targeted interventions to prevent the spread of drug-resistant malaria.
Findings from this research will be shared with the Worldwide Antimalarial Resistance Network (WWARN) to contribute to the global effort against malaria drug resistance.