RAMP

Ravidasvir to combat the emergence and spread of artemisinin resistance in Africa: a phase 2 and 3 clinical trial to assess its efficacy

01.09.2026 bis 31.08.2031

In the context of growing parasite resistance to drugs in malaria, new agents are needed to regain control on this deadly infection affecting mainly children. By a large screen, we uncovered that ravidasvir, licensed by the Egyptian company Pharco and approved with support from DNDi as part of an affordable cure for hepatitis C, is active against asexual and sexual stages of Plasmodium falciparum. In the framework of this EDCTP3 program, we aim to clinically validate the ability of ravidasvir to clear parasites thereby preventing disease resurgence and blocking transmission. The Ravidasvir Against Malaria Parasites (RAMP) project has 3 objectives: assess the efficacy of ravidasvir at reducing parasite carriage and block transmission to Anopheles, assess the ability of ravidasvir to complement Artemisinin-based Combination Therapies (ACT) to sustainably cure patients, and assess perception and compliance of anti-transmission drugs/drug combinations across different countries to inform elimination programs. Drug safety, possible drug-drug interactions and resistance markers will be scrutinized. Our strong, synergistic African - European consortium will initially test ravidasvir as a monotherapy in asymptomatic adults carrying gametocytes in Gabon. We will then evaluate ravidasvir co-administered with a WHO-recommended ACT in adults with uncomplicated malaria attacks in Mali. We will finally perform a non-inferiority Phase 3 trial in Ghana, Gabon, Mali and Uganda, with age de-escalation to rapidly but safely reach African children where artemisinin resistance will be or is already present.
RAMP can rapidly repurpose ravidasvir for malaria, based on its promising, physiologically relevant dual activity in vitro. This cost-effective oral drug, devoid of severe side effects when administered for 12 weeks in hepatitis C, has a very strong potential to be safely co-administered for 3 days with ACT as a protection against parasites resistant to artemisinin and partner drugs.