vaccine


insecticide-treated bed nets on sale; being retreated; and person sleeping under net.

From the CDC: Insecticide-treated bed nets (ITNs) are now a major intervention for malaria control.

Seven years ago, on April 25th, 2000, African leaders from 44 malaria-endemic countries participated in the first-ever African Summit on Malaria, and declared April 25th as Africa Malaria Day. This year, for the first time, the United States will officially commemorate Malaria Awareness Day, celebrating progress and highlighting opportunities in the fight against malaria. To underscore the U.S. commitment to ending malaria related deaths, President Bush embraced the urgency of the cause by designating April 25th, 2007 as Malaria Awareness Day.

Tom Egwang, the director-general of Medical Biotechnology Laboratories in Kampala, Uganda writes in SciDev.Net that Africa should be the driver, not the co-pilot of malaria vaccine development. He writes:

African researchers in resource-poor countries are as competent and knowledgeable as their Northern partners. They publish research articles in leading peer-review journals, present findings at international conferences, read the same literature and attend the same symposia.

So why aren’t they designing malaria vaccines themselves? The stock response to this — as it seems to be to all Africa’s development challenges — is a lack of funds. But putting pen to paper to design a vaccine does not cost money. It takes creativity and innovation — attributes that we on the continent surely possess.

Getting the policy emphasis right

Effective research and development (R&D) does, of course, need funding. But to say that the lack of malaria vaccine R&D in Africa is due to poverty is a lie.

African governments can afford to buy presidential jets and bail out floundering companies. They maintain huge defence budgets and engage in recurrent military adventurism. These actions cost the continent hundreds of millions of dollars — money that could instead be used to develop malaria vaccines.

Similarly, petrodollar profits from oil-rich states like Gabon, Libya or Nigeria could be used to support malaria R&D efforts within and beyond their own borders.

The European Union — a region that has no malaria — currently supports a multi-million dollar network of excellence in malaria research. These funds could, again, have been better spent supporting R&D efforts in Africa.

Misguided funding policies have been accompanied by lopsided training policies that have created a polarised malaria research world.
. . .
African scientists running R&D projects must make herculean efforts to mentor a new generation of Africans to tackle malaria vaccine R&D head-on. This also means lobbying their governments to invest in research — before the North-South divide becomes an abyss.

University curricula should emphasise product development and entrepreneurship. Strategic partnerships with African organisations like the Uganda Industrial Research Institute would facilitate the development of pilot biotechnology projects.

In this way, products developed by academia could be scaled up on a semi-industrial scale for proof-of-concept studies.

African policymakers have hitherto only paid lip service to African science. They must now embrace it as the engine for socio-economic development in Africa, giving it unequivocal and solid financial support.

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Cycle of malaria infection. Plasmodium parasites can reproduce inside the Anopheles mosquito and be transmitted to people through mosquito bites. In people, the parasites can multiply in the liver and in the red blood cells.

The malaria vaccine currently in clinical trials in Ghana is likely to be ready for general release in 2011. From the Accra Mail:

Dr. Seth Owusu Agyei, Director of Kintampo Health Research Centre (KHRC) in the Brong Ahafo Region has stated that he is very hopeful that by the year 2011, the centre would have come out with a malaria vaccine RTS,S, which is currently going through clinical trials, for use in Ghana and across Africa to control malaria.
. . .

Ghana, Kenya, Gambia, Mozambique, Tanzania and Senegal are the six African countries currently taking part in the phase two trials of the vaccine.

He said that Kintampo Health Research Centre and the Kumasi Center for Collaborative Research at Agogo in the Ashanti Region, were conducting the trials on 540 children aged between five and 17 months, and it would last for 20 months.
. . .

He explained, on the average, children in the district between the ages of 6 months to five years get six to seven malaria attacks in a year.

Again on the average, an individual gets about 270 affective bites from mosquitoes.
. . .

He said malaria causes about twenty thousand deaths worldwide; and hopefully with the introduction of the malaria vaccine ten thousand deaths could be prevented.

Dr Owusu-Agyei stressed that, if the trials prove successful after further scientific research, it was expected that by 2011, the RTS,S would be available for use in Ghana and across Africa.

Depending on the success of the current phase two of the clinical trials, the trials will be expanded to phase three in 2008. Phase two emphasizes safety, phase three emphasizes efficacy. And then by 2011, providing the trials go well, the vaccine could become generally available. The challenge will be meeting the cost and providing the funding, to make the vaccine generally available to all those who need it.

For a vivid account of the effects of malaria, and to understand more of why it is so devastating to individuals and communities, see the description of a malaria attack written by Ryszard Kapuscinski, and posted here.

A malaria vaccine is gradually being introduced in Ghana. This is very good news, malaria is devasting to the health and wellbeing of the individual and the community. As the German Press Agency reports:

Malaria affects between 300 and 350 million people – with around one million deaths a year in Africa. Economic loss because of malaria in the world is estimated at 12 billion dollars annually.

In Ghana, about 22 per cent of deaths in children under five, and about 44 per cent of all out-patient department attendances in hospitals, are caused by malaria.

The health ministry points out that the total cost of treating malaria by the individual, household, employers and government is about one-third of the health budget.

So although malaria is a preventable disease, it still accounts for one of the major contributions to poverty plaguing Africa, thereby slowing progress in development.
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The refreshing news is that a version of the vaccine tested on 100 adult volunteers in the United States and 85 adults in Kenya has been found to be safe.

It has already been administered on about 2,000 children aged one to four years in Mozambique. Its results showed that 18 months after the children were vaccinated, the risk of getting malaria was reduced by one third, and the risk of severe malaria by about one half.

The results also showed that the protective effect of the malaria vaccine did not wane 24 months after the vaccine was administered.

For insight into the devasting effects of the disease, see the description of a malaria attack written by Ryszard Kapuscinski, and posted here.