The world's first malaria vaccine, it seems, might not be the answer to the deadly disease. The vaccine, called RTS,S/AS01 (RTS,S), is the world’s first vaccine against malaria that has been shown to provide “partial protection” in young children, according to the World Health Organisation.
The vaccine acts against Plasmodium Falciparum, the most deadly malaria parasite globally and the most prevalent one in Africa, the WHO points out. The vaccine, however, offers no protection against Plasmodium vivax malaria, which predominates in many countries outside of Africa.
“When we began backing the project, it held more promise. But not so much anymore, given that it has only shown partial efficacy,” said Mark Suzman, chief strategy officer and president, Gates Foundation. “Besides, those who get it would need to be re-vaccinated after a period of time, and so it does not work out to be cost-effective,” Suzman said at an interaction with select journalists in New Delhi. Suzman leads the foundation's efforts to build strategic relationships with governments, private philanthropists, and other key partners to increase awareness, action and resources devoted to the foundation's programs in both US and abroad. He also oversees the foundation's regional offices and strategic presence in Europe, Africa, and China, as well as grant portfolios supporting cross-cutting policy research, advocacy, communications, and select country-level delivery efforts.
The Gates Foundation backs projects that most pharmaceutical companies would not put their money into, given the high costs and the time involved in developing a new vaccine, particularly against diseases such as tuberculosis, HIV/AIDS and malaria, he said.
The malaria vaccine is being manufactured by GlaxoSmithKline (GSK), in collaboration with American NGO PATH's Malaria Vaccine Initiative. In 2001, GSK began collaborating with PATH’s Malaria Vaccine Initiative (MVI) to continue developing RTS,S. A five-year Phase 3 efficacy and safety trial was conducted between 2009 and 2014 through a partnership that involved GSK, MVI (with support from the Bill & Melinda Gates Foundation), and a network of African research centres at 11 sites in seven countries. The Phase 3 trial, conducted over 5 years (2009 -2014), enrolled approximately 15, 000 young children and infants in seven sub-Saharan African countries.
The WHO says that among children aged 5–17 months who received 4 doses of RTS,S, “the vaccine prevented approximately 4 in 10 (39 per cent) cases of malaria over four years of follow-up and about 3 in 10 (29 per cent) cases of severe malaria, with significant reductions also seen in overall hospital admissions as well as in admissions due to malaria or severe anaemia”.
The vaccine also reduced the need for blood transfusions, which are required to treat life-threatening malaria anaemia by 29 per cent, the global health body says. The WHO and its partners are engaged in “intensive discussions with stakeholders” to plan for the vaccine introduction and evaluations in selected countries, and the vaccinations are due to begin in 2019.
In India, though, Suzman said that the foundation's strategy on malaria would be around encouraging the use of bed nets and providing better treatment to affected people. He clarified to THE WEEK that the Gates Foundation does not work on malaria programmes in India, yet. In Africa—where the vaccine has held much hope—Suzman said that the philanthropic organisation strategy would focus on encouraging the use of bed nets and providing better treatment to the affected populations.
India contributes 70 per cent of malaria cases and 69 per cent of malaria deaths in the South-East Asia Region. By 2030, the centre is targetting to a “malaria-free” status for the country.
