Anyone who has traveled to the jungles of Central America, or the hot, semi-tropical lands of the sub-Sahara, has probably had to deal with the risk of contracting malaria. Some of my earliest memories as a child date back to my introduction to the bitter taste of quinine tablets and the counseling I received from my father, a scientist, of the importance of not missing a single dose. Guatemala’s tropics, while not the most dangerous region for malaria infection, harbors its own challenges for life expectancy, and it was my father’s work as a nutritionist that gave him a personal understanding into the risks of malaria, and the heartbreaking outcomes of complications from the disease. Quinine, mosquito nets and bug repellant were not absolute protection against malaria, but they were considered essential in Central America’s tropical zones.
“Someday they’ll figure out how to make a vaccine,” I remember him saying wistfully, “but probably not in my lifetime.”
His predictions were right. While he didn’t have the opportunity to see that accomplishment, he probably would have taken solace in knowing that it would occur a lot sooner than he expected.
Last Monday, the European Union Human Medicine Regulatory Agency announced that the first vaccine against malaria had been approved. Mosquirix or RTS,S from British pharmaceutical company Glaxosmithkline was developed in partnership with the Malaria Vaccine Initiative and a whole host of private and public sponsors. It has been approved for children aged 6 months to 17 months of age, who are particularly at risk for malaria infection in sub-Saharan Africa.
The Bill and Melinda Gates Foundation provided $200 million toward the vaccine’s development, which also received clinical development assistance from the Walter Reed Army Hospital. The U.S. Agency for International Development, ExxonMobil Foundation and the Global Health Innovative Technology Fund also chipped in.
The collaborative effort also opens the door for malaria vaccine development that can cover a wider spectrum of ages and needs. The vaccine that was developed targets the most dangerous species of malaria carriers, the Plasmodium falciparum parasite, but has only been shown to be effective in certain age groups.
Disease and related issues like malnutrition kill at least 10 percent of children below the age of 5 in sub-Sahara (amounting to 1 in 9 children in 2012), but developing vaccines that can target the other four parasites that carry malaria may now be a possibility. More than half of the world’s population lives in malaria-infested regions, and at least half a million people of all age groups die from malaria or complications related to the disease each year.
Perhaps just as significant an accomplishment is the fact that the vaccine will be essentially not-for-profit. The global collaboration on this vaccine sets a bar that HIV and AIDS research struggled to meet for years: developing a mechanism where a vital medication could be dispensed in an affordable way that would expedite treatment and yet cover the significant costs of research. Galaxosmithkline, which has worked on the vaccine for 28 years, has agreed to offer the malaria vaccine at cost with a 5 percent markup that will be invested back into research for new vaccines.
It isn’t unusual for foundations and other nonprofits to invest significantly in medical research, but the potential impact of this breakthrough gives hope for many types of preventative vaccines, not just those that target the transmission of malaria. And that’s the beauty of this accomplishment. Parasitic infections that occur as complications to poor nutrition, extreme poverty and environmental conditions may one day be preventable through vaccination. The economic and humanitarian implications of being able to lower child mortality rates with a series of vaccines — with private-public sponsorship — benefits everyone. It’s a turning point, however preliminary, that one scientist, bent on doing his part to eradicate global malnutrition, would certainly have been proud of.