October 23, 2011
Two Cheers for the Malaria Vaccine
A vaccine to protect children against malaria has been shown moderately effective in a large clinical trial — an achievement that could save millions of lives. The vaccine, known as RTS,S and made by GlaxoSmithKline, is the first ever to be shown effective against a human disease caused by parasites. When tested in 6,000 infants ages 5 to 17 months in seven sub-Saharan nations, it reduced the risk of infection with severe malaria by 47 percent during the year after the shots, far less than the 90 percent efficacy rate typically sought for other vaccines. And there are other big hurdles still to surmount. There are hints that the protection may wane over time and results from administering a booster shot won’t be known until 2014. Side effects could pose a problem; seizures and fevers were higher among children given the vaccine.
If final results of this ongoing study, which involves more than 15,000 children in all, show that the vaccine is safe and effective, the goal is to deploy it in 2015.
Glaxo has pledged to sell the vaccine at its manufacturing cost plus 5 percent that will be spent on research on malaria and neglected diseases. The company has not set a price, and, once it does, international donors and African health systems will have to find the resources to buy and administer it at a time of global recession.
The Bill & Melinda Gates Foundation deserves major credit. Glaxo spent $300 million over 25 years to develop the vaccine for military personnel and travelers but was unwilling to pay for pediatric trials for impoverished nations without a partner. The Gates Foundation donated $200 million to drive the research to completion, and Glaxo expects to add another $100 million of its own.
The fight against malaria has made gains thanks to effective drug treatments, insecticide-treated bed nets and programs to spray the interior walls of houses. With the vaccine, health experts are talking with renewed optimism about eradicating malaria entirely (some countries already have). But it will take vigilance and money to stay ahead of resistant mosquitoes and parasites.