Malaria is an infectious disease common to several parts of the world, including Africa, northern South America, and Asia. During their service in the military, U.S. active members may be sent to any part of the world, including parts of the world where Malaria is an issue. In Liberia in 2003, for example, there was a 28 percent attack rate in Marines who spent a short time ashore, and half of the 80 Marines affected needed to be evacuated to Germany. This was not only costly to the U.S. military but dangerous as well. To fight against this disease, there exists a Malaria Vaccine program in the U.S. military. However, there exists a variety of potential vaccine targets for the most severe and important form of malaria; malaria from the species Plasmodium falciparum. Issues also arise with the fact that there are three possible stages to create vaccines against-preerythrocytic, blood, or transmission. The Department of Defense (DoD), through the commanding general of the U.S. Army Medical Research and Materiel Command (USAMRMC), requested that the Institute of Medicine (IOM) conduct a programmatic review of the military Plasmodium falciparum malaria vaccine research and development program. There was to be a focus on vaccine against the preerythrocytic and blood stages. The IOM formed a committee of 11 experts with collective expertise in malaria vaccine research, parasite immunology, malarial biology, clinical trials and regulatory affairs, industrial and public-sector vaccine development, biologic products research and development (vaccinology), military research and development programs, tropical medicine, and public health. The committee focused different tasks including determining whether the DoD malaria vaccine research and development program is scientifically sound and able to achieve the vaccine program objectives within specified timelines, recommending how to overcome significant, identified barriers, and identifying major strategic goals and timelines based on the material received and presentations made by the DoD's program representatives. Battling Malaria: Strengthening the U.S. Military Malaria Vaccine Program presents the committee's findings, current malaria vaccines, and recommendations for the development of the U.S. Military vaccine research. Table of Contents Front Matter Summary 1 Introduction 2 The Malaria Threat and Need for a Vaccine 3 Malaria Vaccines 4 The U.S. Military Malaria Vaccine Research and Development Program--Scientific Aspects 5 Organization and Management of the Program References Appendix A Vaccine Trials Appendix B Current Requirements for a Malaria Vaccine Appendix C Suggested Design of Trials for Testing Malaria Vaccines in Nonimmune Adults Visiting Endemic Areas Appendix D Patents Appendix E Scientific Advisory Board for DoD Malaria Vaccine Research and Development Program (Draft Charter) Appendix F Recommendations of the IOM Report Protecting Our Forces Appendix G Executive Summary and Recommendations of the DoD Report Acquisition of Vaccine Production Appendix H Open Meeting Agenda Appendix I Committee and Staff Biographies