Development of a transmission-blocking malaria vaccine: progress, challenges, and the path forward.

New interventions are needed to reduce morbidity and mortality associated with malaria, as well as to accelerate elimination and eventual eradication. Interventions that can break the cycle of parasite transmission, and prevent its reintroduction, will be of particular importance in achieving the eradication goal. In this regard, vaccines that interrupt malaria transmission (VIMT) have been highlighted as an important intervention, including transmission-blocking vaccines that prevent human-to-mosquito transmission by targeting the sexual, sporogonic, or mosquito stages of the parasite (SSM-VIMT). While the significant potential of this vaccine approach has been appreciated for decades, the development and licensure pathways for vaccines that target transmission and the incidence of infection, as opposed to prevention of clinical malaria disease, remain ill-defined. This article describes the progress made in critical areas since 2010, highlights key challenges that remain, and outlines important next steps to maximize the potential for SSM-VIMTs to contribute to the broader malaria elimination and eradication objectives.

STD program activity in state policy processes, 1995 and 2000.

BACKGROUND: Generating state policy support for sexually transmitted disease (STD) prevention is crucial; however, little is known about policy activity by STD programs. GOALS: The goals of the study were to identify state-level policy behaviors by state STD programs and to examine the association between policy behavior and selected state characteristics. STUDY DESIGN: Information was gathered through a survey of STD directors in 2001. Policy activities were recalled for 1995 and 2000 and compared with several state characteristics. RESULTS: A majority of state STD programs reported at least one policy behavior in the state policy process for 1995 and for 2000. An increase was observed with the provision of state legislative testimony, participation in STD coalitions, and dissemination of information to policy-makers by STD programs. CONCLUSION: Reported policy activity may be evidence of an emerging environment enabling state STD directors to engage in public policy activity. An opportunity exists to improve state and local support for STD prevention.