Equitable access to monoclonal antibodies targeting parasites

Monoclonal antibodies (mAbs) have reshaped prevention and treatment of infectious diseases. However, the development of mAbs against parasitic diseases that disproportionately impact populations in resource-limited settings has received lower priority. Recent trials in Africa show that long-acting mAbs can prevent Plasmodium falciparum infection in children and adults. Early studies suggest that mAb pharmacokinetics differ between malaria-endemic and nonendemic populations, with age and prior parasite exposure possibly affecting the minimum amount of mAb required for durable protection. We present evidence that antiparasitic mAb studies should account for fragment crystallizable receptor polymorphisms and host factors commonly found in endemic populations. We discuss economic and manufacturing barriers to accessing mAbs in resource-limited settings, which have implications for the future use of these promising interventions.