Malaria vaccine is in the works

NAIROBI, Kenya — A vaccine against malaria to save the lives of hundreds of thousands
of children a year could be available as early as 2012, according to African scientists who are testing the new drug.

There are 247 million cases of malaria every year leading to the deaths of 881,000 people, as reported in GlobalPost's "Bug Wars" series. A total of 3.3 billion people are at risk of malaria in 109 countries. But the worst impact is in Africa and on children: 90 percent of the malaria deaths are in Africa and 85 percent of all the deaths are children under 5 years old.

“We believe that a vaccine for malaria could help save countless lives and redefine the future of African children,” said Dr. Patricia Njuguma, one of the vaccine’s principal investigators, based in Kilifi, Kenya. “Working as a pediatrician I see everyday the effect of malaria on children. I see … the concern mothers have when their children have high fever, convulsions or lapse into coma.”

An international team of scientists announced late in 2009 that the world’s largest trial of a vaccine called RTS,S — or Mosquirix — is underway in seven African countries in order to determine the effectiveness and safety of the drug on a large scale.

The trial is to involve 16,000 children in Kenya, Tanzania, Malawi, Mozambique, Gabon, Ghana and Burkina Faso, all within the malarial belt that stretches across sub-Saharan Africa.

“The first child was vaccinated in Bagamoyo … and to date we have over 5,000 children already vaccinated,” said Dr. Salim Abdulla, the other lead investigator, who works in the seaside town of Bagamoyo in Tanzania.

RTS,S is the most likely candidate to be rolled out as a malaria vaccine in the coming years. According to one of its inventors, Dr. Joe Cohen, a research scientist at GlaxoSmithKline Biologicals in Belgium, the vaccine might be available as early as 2012.

“This is the culmination of more than 20 years of work,” said Dr. Cohen. “Never before has a vaccine been developed against a human parasite, let alone a devilishly complex parasite such as the one responsible for malaria.”

This next stage of testing is expected to last between three and five years at which point there should to be enough information for national regulatory authorities to decide whether to license the vaccine in their countries.

Ultimately the decision will be theirs but Dr. Christian Loucq, director of the non-profit PATH Malaria Vacine Initiative, largely funded by the Bill and Melinda Gates Foundation, was optimistic and insisted that countries should prepare themselves now to ensure rapid distribution of the vaccine when it is ready.

“The vaccine will have to prove … its efficacy and safety, but … we need to get ready today for the vaccine to be available for the children. Today [African governments and international organizations] have to start being prepared and committed.

“We need to start thinking of uptake. So many times a vaccine has been made available and has been [left] on the shelf for a couple of years. We want the vaccine to be used the day it is made available,” said De Loucq.

Besides getting the all-clear from governments another major barrier will be cost, given that the vast majority of those suffering and dying from malaria are the poorest people in the world’s poorest countries.

However, GSK chief executive Andrew Witty said recently, “We’re not going to let price get in the way of access for malaria vaccines. We will be extremely responsible about the way we price this vaccine.”

Though thin on detail the promise was reiterated by the scientific research team.

The vaccine would be an important weapon in the fight against deadly malaria but would be just one part of an arsenal that includes insecticide-treated bed nets, indoor spraying, effective treatment once malaria takes hold and preventative anti-malarials for pregnant women. Even pop music is being used to spread education about preventing malaria.

In earlier phases of the clinical trials of RTS,S that have been ongoing since 1992 it has been shown to reduce malaria by 53 percent in children aged between 5 and 17 months and to reduce by half severe life-threatening malaria in children under 5 years old.

“For the sake of African children … we must move ahead with this vaccine,” said Dr. Cohen.