Toward a Malaria-free World

Two cheers for recent malaria trials in Tanzania that show reductions in the incidence of childhood malaria. Just two cheers, though, because this vaccine, directed against parasites, is only half as effective as vaccines against viruses: about a fifty percent efficacy rate compared to ninety-plus percent.

Still, it’s the first time we’ve had a vaccine this effective against a disease caused by parasites and it is a promising push against malaria’s grim statistics. Around the world, malaria hits millions of people and kills nearly a million annually. Most of these are young children and pregnant women. In Tanzania alone, over twenty thousand people die of malaria every year. It’s the number one cause of death for children under the age of five.

Eradicating malaria once seemed well-nigh impossible. The vaccines we are familiar with (for measles, mumps, rubella, etc.), are directed against viruses that are simple organisms compared to parasites. Malaria is carried by a complicated mosquito-borne parasite that morphs into different forms in the human body so a vaccine has to be pretty adept to destroy it all. This ghastly-looking creature has already sucked blood out of someone with malaria so, if she bites you next, you might get malaria:

Twenty-five years ago, the big pharmaceutical company GlaxoSmithKline put money into research on a malaria vaccine for adults with the idea of selling it to the Department of Defense for military personnel. They couldn’t produce a vaccine for adults but some of their scientists concluded that the results were promising for a vaccine directed at children.

But Glaxo was unwilling to put up money for further research since the market for a vaccine for children was not the well-funded US Defense Department but poor countries unable to pay high prices. Several years ago this came to the attention of the Bill and Malinda Gates Foundation which donated the money to fund clinical trials for 15,000 children in Tanzania and six other countries in sub-Saharan Africa. The result is an efficacy rate of fifty-seven percent in cases of severe malaria in children between the ages of five and seventeen months old.

More trials are needed over the next two years to find out how long this protection lasts. These trials will involve studying the efficacy of booster shots and continued monitoring to establish the extent of side effects. If all goes well, a vaccine for children could be in the field by 2015.

If that happens, there will be a scramble in Africa to find money to buy Glaxo’s malaria vaccine. Health budgets in sub-Saharan Africa are already strained and Glaxo will not subsidize this vaccine with profits from its lucrative drugs. So, international donors and health care systems in poor countries will have to find additional resources to buy this vaccine as part of a slow but steady world-wide campaign to keep pressing in on malaria’s deadly borders.