Speaking at a leadership development course in Abuja titled “Science of Defeating Malaria”, Dr. Wells stressed that progress made over the past two decades could be undermined if drug resistance is not anticipated and addressed proactively.
“We have the tools to get around resistance at the moment, but what we do not want is a situation where all available drugs fail and there is nothing ready to replace them,” he warned.
Lessons from history: when chloroquine stopped working
Dr. Wells pointed to historical setbacks in malaria control, particularly the widespread resistance to chloroquine in the 1960s, which disrupted earlier elimination efforts.
That experience, he suggested, remains a cautionary reminder that even highly effective medicines can lose their power over time if resistance emerges faster than scientific innovation.
While current treatments remain effective, he said the risk is not theoretical—it is predictable based on past patterns of parasite evolution.
Expanding protection beyond children under five
Malaria interventions have traditionally focused on children under five, who bear the highest mortality burden. However, Dr. Wells argued that future elimination strategies may need to broaden coverage.
“However, future elimination efforts may require broader protection that extends to older children, adolescents, adults and pregnant women,” he said.
Some countries are already testing expanded use of Seasonal Malaria Chemoprevention (SMC) beyond its traditional target group, while researchers are working on treatments designed for wider population coverage.
Long-acting malaria injections under development
Among the most promising innovations discussed was the development of long-acting injectable medicines that could provide protection against malaria for several months.
Drawing parallels with advances in HIV prevention, Dr. Wells said researchers hope to create a single-dose injection capable of offering protection for up to six months.
Such a development, if successful, could significantly reduce infection rates in high-transmission regions by minimizing the need for frequent dosing and improving adherence.
New scientific approaches targeting mosquitoes themselves
Beyond traditional drug therapies, researchers are also exploring ways to disrupt malaria transmission at the vector level.
Dr. Wells highlighted experimental approaches that aim to prevent mosquitoes from feeding or transmitting parasites, describing them as a complementary strategy to drug-based prevention.
“We know it is possible to use medicines that can interrupt the ability of insects to feed and transmit disease,” he explained, noting that similar techniques are already used in veterinary medicine and are now being studied for human application.
Long road from discovery to deployment
Despite scientific progress, Dr. Wells cautioned that developing and deploying new malaria medicines remains a slow process.
Clinical trials involving both adults and children can take six to seven years, followed by additional layers of regulatory review and approval before treatments reach patients.
He emphasized that this timeline makes early preparation essential, especially in the face of evolving drug resistance.
Strengthening Africa’s regulatory systems
Dr. Wells expressed optimism about ongoing reforms in Africa’s health regulatory landscape, saying they could accelerate access to new treatments.
He pointed to the emergence of the African Medicines Agency and improvements within national regulators in countries such as Nigeria, Ghana, and Rwanda as key developments.
Stronger institutions, he said, would allow African countries to evaluate and approve medicines more independently, reducing reliance on external regulatory bodies and speeding up access to life-saving innovations.
“Countries are increasingly building the capacity to evaluate and approve medicines independently. That may sound like a technical issue, but it is a major step forward because it gives African nations greater control over the health tools they need,” he said.
“Preparedness is everything”
As malaria-endemic countries push toward long-term elimination goals, Dr. Wells emphasized that sustained investment in science, innovation, and regulation will determine future success.
Preparedness, he argued, is not optional—it is what will prevent decades of progress from being reversed if resistance to current treatments eventually emerges.
The message from Abuja was clear: the fight against malaria is not only about using today’s tools effectively, but also about ensuring tomorrow’s tools are already in the pipeline.