Earlier this week the New England Journal of Medicine published the results of a promising clinical trial of a vaccine for malaria. UN Dispatch spoke with Dr. Daniel Carucci Vice President of Global Health for UN Foundation, described what this breakthrough means for the global fight against malaria.
Can you explain the significance of news this week that a malaria vaccine has apparently proven effective?
The New England Journal of Medicine reported this week that an experimental malaria vaccine, called RTS,S, that has shown promise in clinical studies in adults in the U.S. and in early studies in adults and children in Africa, showed comparable efficacy in infants, the population that would most benefit from the vaccine. In all of the studies conducted so far in Africa, the vaccine seems to give between 30% and 50% protection against getting ill from malaria, much lower than any vaccine for other infections on the market today. The malaria vaccine was also studied in combination with the standard vaccines that infants typically receive against diphtheria, pertussis, tetanus, hepatitis B and Haemophilus influenzae type b to ensure that the malaria vaccine did not interfere with these vaccines. Despite the fact that the vaccine does not provide 80 to 90% protection that would be hoped for, this vaccine is the best candidate to date that has been tested in Africa. Other vaccines are in earlier stage development and some could potentially be combined with this vaccine to improve its efficacy.
The good news is that there is strong evidence that an effective vaccine can be developed. Two reasons for this beyond this week’s news are that first, children can develop natural immunity to severe malaria if they live in a malaria area and survive being infected. Second, that laboratory volunteers who are bitten by infected mosquitoes that have been experimentally weakened are completely protected against malaria. These two experimental models give researchers hope that an effective malaria vaccine is possible. The results this week represent an important leap towards this important goal.
When can we expect this vaccine to be available for wide-spread use in sub-Saharan Africa?
Once the vaccine completes its final stage of development and if it is licensed, it could be available in 5-8 years. Other vaccines, if there are shown to be effective, may be as much as 10 years away from licensure.
Does a vaccine potentially obviate the need for other anti-malaria measures?
Until a vaccine is developed that is over 90 to 95% effective, children and pregnant women will still need to be protected from the bites of mosquitoes through the use of insecticide treated bed nets and will have to be checked and treated for malaria. Mosquito control through insecticide spraying of houses and eliminating standing water will need to continue.