Malaria vaccine in the offing

NAIROBI - Patricia Njuguna knows all too well the suffering of her little patients at the children’s clinic in Kilifi. “Every day I have severe cases of malaria: children with high fever and convulsions, children who go into a coma,” the paediatrician said. “And I see the mothers’ helplessness.”

A town on Kenya’s Indian Ocean coast, Kilifi is a holiday paradise for the foreign tourists in air-conditioned hotels. But the town’s fishermen and farmers cannot cool their homes down to temperatures that make mosquitoes infected with the malaria parasite passive.

Not all of them sleep under a mosquito net treated with insecticide, a protection enjoyed by just 26 percent of the population in Africa’s malaria-risk areas.

The fatality rate is especially high for small children. Every 30 seconds on average, a child dies of malaria somewhere in the world, 90 percent of them in Africa. Some 247 million people contract malaria each year and 3.3 billion live in malaria-risk areas.

Fighting the disease, which mainly affects the world’s poorest people, was the aim of the 5th Multilateral Initiative on Malaria (MIM) Pan-African Malaria Conference in Nairobi earlier this month. The scientists, health care workers and government officials in attendance exchanged experiences and discussed treatment methods and new medicines.

The parasite causing the disease has developed resistance to a number of malaria medicines. Conference participants held out hope for the first malaria vaccine, however. After more than 20 years of research, phase-III trials of the promising RTS,S vaccine have begun.

Up to 16,000 children in seven African countries are to be vaccinated.

“Twenty years ago, a malaria vaccine was a distant dream. Now it’s within reach,” remarked Salim Abdullah, director of the Ifakara Health Institute in Tanzania and one of the African scientists involved in the vaccine project. He said earlier phases of the trials had shown that RTS,S could be given to infants along with their standard vaccinations.

“In the previous phases of the trials, the vaccine was effective for up to 45 months,” said Joe Cohen, a researcher for GlaxoSmithKline (GSK) Biologicals in Belgium and one of the vaccine’s developers. “In phase II, 50 percent of the vaccinated children were then immune to malaria or became only slightly ill.”

Since the vaccine did not provide 100-percent protection, everyone involved in the project is being careful not to arouse excessive expectations. “The vaccination complements and supports the existing protective measures,” Cohen stressed. So insecticides and mosquito nets will still be necessary in risky areas.

Nevertheless, the mothers of the 5,000 children enrolled so far in phase-III trials are keen on the added protection they hope the vaccine will give.

If the latest testing phase proves successful, researchers and medical professionals aim to apply to regulatory authorities in three to five years for approval to market the vaccine.

The next step would be to make it available to as many children in developing countries as possible — through the United Nations Children’s Fund and other international organisations, for example.

“Africa’s children deserve a better fate than to die of malaria,” Cohen said. “We owe it to them to bring this work to a good conclusion.”