I’ve done quite a few posts on the eradication of communicable diseases recently and so I feel it would be remiss of me to leave out one of the biggest killers still stalking the planet. So far this year malaria has infected a quarter of a billion people and killed nearly half a million, many of them children. We have been engaged in an arms race with the malaria-causing Plasmodium parasite for many decades now. Every now and then we gain an upper hand with the development of some new anti-malarial drug, as detailed in a recent post, but it normally only takes a few years for the parasite to begin evolving resistance and beating us back again. The holy grail would be to develop a fully effective, cheap, easily produced, easily stored vaccine that could protect everyone.
Hopes of such a treatment slowly rose as GlaxoSmithKline (GSK) revealed it was working on a childhood anti-malarial vaccine. Unfortunately, though, initial small scale trials in 2011 and 2012 showed that the vaccine was not nearly as effective as might be hoped. In babies aged 6-12 weeks it was 27% effective, and in children aged up to 5 years it was only 46% effective. Also, the regimen involves 4 doses spread over several months, an almost insurmountable barrier in some parts of the world where this vaccine would be most needed.
The vaccine was assessed over recent months by the World Health Organisation Strategic Advisory Group of Experts; they were looking to see if the vaccine should be rolled out on a huge scale worldwide. Their recommendations were cautious, however, suitably so considering the treatments limited efficacy and relative high cost of $20 for the full course. They have asked that a half dozen or so demonstration projects be carried out involving, perhaps, a million or so children to see how practical it is to administer 4 doses in countries where infrastructure would make it difficult to do so. Although a sensible precaution it is thought that this would push back any potential large scale deployment by several years. This is particularly disappointing as the next nearest malaria vaccine in development is probably still a decade or so away, the thinking is that it’s better to be patient and throw billions of dollars at the right treatment instead of wasting that money on one now which won’t get the job done.
One further note: you’ll have noticed that it is GSK developing this vaccine, one of the poster boys of evil Big Pharma. Whilst I would never claim that large pharmaceutical companies are saints working solely for the benefit of mankind I do think that they face a lot of wholly unjustified criticism. GSK, along with the Bill and Melinda Gates Foundation and other partners, have spent 30 years and over half a billion dollars working on this one vaccine. The price of the vaccine is the cost of manufacture plus a modest mark up of 5% all of which would be ring fenced by the company for future research into other tropical diseases. So fair’s fair, they’re not all bad.