**5. Perspectives**

WHO has announced an ambitious goal of global malaria elimination by 2030. Malaria elimination is possible but will require adaptive and well-managed programs and the implementation of evidence-based surveillance strategies and strong national responses, with adequate funding and human resources.

Over the past 20 years, significant progress has been made in the fight against malaria worldwide, with impressive reductions in transmission in many endemic regions. However, the successful outcome of the global malaria eradication research program will depend on the development of new and more effective tools, including rapid diagnostic tests, drugs, vaccines, insecticides, and awareness raising. Nowadays, genetic and genomic knowledge of malaria parasites, vectors (mosquitoes), and human hosts are available. These bits of knowledge could and should be used for the development of the latest generation tools that are more efficient and secure. The situation is all the more urgent and worrying as there is the emergence of a resistance of *Plasmodium falciparum* to the first-line drug, namely artemisinin.

In any event, the development of an effective, safe and operational malaria vaccine remains the ultimate objective that we must achieve. In this perspective, we must watch and take into account the genetic variation of the parasite population, which threatens to undermine our efforts.

A big significant milestone in scientific advancements of the last twenty years was already the elucidation of the genomes, transcriptomes, and proteomes of many pathogens, including malaria parasites. These informations give a clearer and more detailed picture that provides the foundation for new approaches to refine existing targets as well as to identify new target antigens for the development of more efficient and effective vaccines, drugs and diagnostic tests. It is clear that further progress is needed for the development of a malaria vaccine, based on basic research, in order to identify new target antigens and better understand how different adjuvants will affect balance, sustainability, and the effectiveness of the responses. To hope for an effective vaccine, emphasis should be placed on mixtures of antigens combined with potent adjuvants, not only to induce the necessary effective responses, but also to increase the possibility of inducing at least partial cross-immunity by including a range of Plasmodium epitopes.

Innovative genome-based vaccination strategies have shown the potential of a number of pathogens, including malaria. A rational genome-based vaccine design, allowing the selection of the best possible targets by prioritizing antigens according to clinically relevant criteria (frequency and magnitude of the clinically relevant immune response and/or biological function), will overcome the problem of poor immunogenicity and poor vaccine protection that have undermined the development of malaria vaccines in the past 30 years.

The use of gene drive technology could revolutionize ecosystem management. These emerging technologies with potential global effects are being offered to researchers and now subject to public discussions regarding environmental and safety concerns. The relative protection against malaria that heamoglobinopathies would confer, justify justly that we are still investigating this correlation to determine all its nature and its power. Despite this relative advantage over the

*Inherited Disorders of Hemoglobin and* Plasmodium falciparum *Malaria DOI: http://dx.doi.org/10.5772/intechopen.93807*

manifestations of malaria in subjects with sickle cell trait, gene therapy is a new approach to healing patients with hemoglobinopathies, which must be popularized. In this sense, clinical trials are underway with promising results. However, there are still frontiers to explore that could improve this approach: the stoichiometry between transgenic hemoglobin and endogenous hemoglobin in relation to the different genetic mutations of globins; the supply of donor cells, such as the use of induced pluripotent stem cells (iPSC); and the use of safer gene insertion methods to prevent oncogenesis.

The overall prospects for malaria elimination are clear, encouraging and the potential opportunities are endless. Technological discoveries and advances are happening at an incredibly fast pace. The context of discovery and use of new technologies makes the eradication of malaria within the reach of the test tube. However, regardless of the time it will take, we must increase our efforts; intensify networking, with the financial support and strong political will of our leaders, especially in Africa where the problem of malaria is the most important.
