The Malaria Vaccine Breakthrough

Acclaimed as a “historic event” and as a “breakthrough for science”, the first malaria vaccine has been approved by the World Health Organization (WHO) on the 6th of October. The shot has been developed by the British pharmaceutical company GSK and is the result of a pilot research that has been conducted in Ghana, Kenya and Malawi. Although the new scientific achievement has limited effectiveness on malaria, it will still prove to be very effective to challenge such a deadly disease. The virus has claimed around 409.000 victims in 2019 alone, 67% of which were children under the age of 5 years old. For these reasons, researchers perceive the shot as an additional way to counter the illness that is afflicting in the overwhelming majority the African continent. Nonetheless, there are still barriers to the distribution of the medicine. Indeed, after the approval, the responsibility lies on governments to acquire the doses and set up efficient shot campaigns that could reach even the most remote areas.

According to the WHO reports, malaria has been the cause of 219 million cases in the world and 435.000 casualties in 2017. The region that is hit the heaviest by this illness is Africa, which counts for around 93% of all malaria deaths. According to experts, the sickness kills one child every two minutes.

Malaria is a very tricky and complex parasite, far more difficult to understand than the Coronavirus. For this reason, it is very difficult for scientists to grasp and therefore, to develop a remedy. Since the 1940s, researchers have experimented with more than 140 different vaccines on humans to fight the illness. However, none of them was able to attain the level of effectiveness that would allow them to be certified by international health organizations. When comparing the difficulty between understanding the SARS-CoV-2 and malaria, Jason Kindrachuk, a virologist at the University of Manitoba in Winnipeg, has commented that “(V)iruses, certainly are very complex … [but] when you’re doing vaccine development, it’s very straightforward”. According to him, when analysing parasites “we’re talking about organisms that are responsive to their surroundings and can change and adapt”, which makes it hard to develop a cure for. Recently, the deadlock in studying the parasite had stalled the progress in fighting the disease, leading to a halt in the decrease of cases in the last 5 years.

The newly approved vaccine, named Mosquirix or RTS,S, is the result of a pilot program that was deployed throughout Ghana, Kenya and Malawi. Since 2019, the British pharmaceutical company GlaxoSmithKline (GSK) has carried out shots campaigns that have seen the distribution of the medicine to more than 800.000 children. Compared to the alternative methods used to fight against malaria, such as insecticide-treated bed nets and drug treatments, this approach can reach remote areas too. As commented by the WHO regional director for Africa, Dr Matshidiso Moeti, “(W)e know the power of vaccines to prevent killer diseases and reach children, including those who may not have immediate access to the doctors, nurses and health facilities they need to save them when severe illness comes”.

Nonetheless, several analysts have criticised the vaccine affirming that its effectiveness is very limited. Mosquirix can prevent only 39% of the disease’s cases and 29% of the severe strand of malaria. However, due to the wide circulation of malaria in Africa, projections still estimate that the remedy will be able to prevent around 23.000 children’s deaths a year. Professor Sir Brian Greenwood from the London School of Hygiene and Tropical Medicine (LSHTM) has affirmed that “(T)he RTS,S vaccine does not provide complete protection but this decision is testament to the global health community’s drive and vision to find a way forward. As part of a tailored approach, it has great potential to reduce death and illness in high burden areas, especially when combined with other interventions such as seasonal malaria chemoprevention and bed nets, and be a huge boost to malaria control efforts”. Indeed, an LSHTM conducted in August 2021 observed that a combination of the antimalaria drugs and the vaccine administered before the rainy season could decrease by 70% the hospitalisations and deaths from the sickness among kids. For these reasons, although the battle against malaria is far from over, Mosquirix has still been acclaimed by the WHO General Director Tedros Adhanom Ghebreyesus as a “historic moment” that “changes the course of public health history”.

Yet, now that the medicine has been officially approved, another challenge could delay its mass dissemination in the African continent. The broader vaccination campaign will have the possibility to start only after the approval of the individual African countries and the billions of dollars funding through governments and organizations. The pharmaceutical company GSK has pledged to supply up to 15 million doses a year at a price that is no more than 5% higher than the cost of production. However, the firm’s Chief global health officer Thomas Breuer has underlined that “(T)he international funding community has to now discuss and then decide how to procure the vaccine”, to expand the distribution as wide as possible.

Mosquirix represents an invaluable change to turn the African continent’s destiny around. However, after the scientific success, the progress will now fall into bureaucratic and political hands. The outcome of this breakthrough, as well as future medical experiments, will depend on governments' and institutions' willingness to fund the research. As ascertained during the Coronavirus pandemic, only international cooperation and continuous funding will bring forth pharmaceutical prouesse. As such, Colin Sutherland, professor of parasitology at the LSHTM has warned that “(P)harma needs strong partnerships and incentivisation to work in tropical disease drug and vaccine development. In fact, malaria vaccine success (and indeed Covid vaccine success) has not come just from private enterprise working alone, but from a complex ecosystem of co-operation and innovative funding mechanisms involving academia, pharma, international charities and substantial amounts of direct government funding (from the UK, EU, USA and other countries)”.

Written by Cinzia Saro

Cinzia Saro is a columnist at DecipherGrey.