Knocking out Malaria

The first vaccine for one of the world’s most deadly diseases is on the way

By Corey Binns Posted 02.17.2009 at 1:47 pm 6 Comments

Common Killer An infant receives a vaccine in Kenya. Karen Kasmauski/Getty Images

A vaccine with a 53 percent success rate doesn’t normally call for a celebration. But when that means protecting one in every two African children from a disease that kills a kid every 30 seconds, those odds start looking better. “The impact is tremendous,” says Joe Cohen, inventor of the first malaria vaccine. “We could save hundreds of thousands of kids every year.”

This spring, pharmaceutical giant GlaxoSmithKline will enroll 16,000 infants and toddlers, the groups most at risk, in what could be the largest malaria-vaccine trial to date in Africa, setting up labs in 11 hospitals in Kenya, Burkina Faso, Malawi and four other countries. The test follows on the success of recent small-scale studies in Kenya and Tanzania that reduced infection by 65 percent in infants. “We’re going to make sure the vaccine works everywhere in sub-Saharan Africa,” says Cohen, vice president of R&D for Vaccines for Emerging Diseases and HIV at GSK. If this final clinical trial replicates the results of previous studies, the company hopes to submit the vaccine for regulatory approval in 2011, with the ultimate goal of including it in the World Health Organization’s free infant-immunization program, which covers measles, tuberculosis and other diseases.

Deadly insect: Anopheles mosquito. getty images

Until now, malaria, contracted when a female Anopheles mosquito carrying the Plasmodium parasite bites a human, has proved impossible to eliminate in tropical and subtropical developing nations, particularly in sub-Saharan Africa. There, parasites and mosquitoes have grown resistant to antimalarial drugs and insecticides, and 90 million children don’t have access to mosquito-proof bed nets. “These preventative methods are good,” Cohen says, “but an effective vaccine is essential for controlling malaria.”

The half-century-long road to a vaccine has been hampered by the parasite’s complex life cycle, shifting genetic makeup and unique ability to evade the immune system. After an infected mosquito bites a person, the parasite heads to the liver, invades red blood cells, and multiplies until the cells burst. If the invasion persists, it can shut down a child’s nervous system in hours. Many die of liver and kidney failures. Survivors suffer from anemia and brain damage.

Cohen’s formula could finally bring relief. The vaccine, called RTS,S and originally developed for the U.S. military, targets a protein specific to the parasite’s surface. A one-time exposure to this protein helps a child’s immune system prepare an army of antibodies that will detect the parasite and order immune cells to kill it—or at least inhibit its ability to multiply—the instant it hits the blood.

Even reducing the toll the disease exacts on global health and economies would be a success. Malaria kills one million people annually, most of them children younger than five, and sickens another 500 million. The disease accounts for 40 percent of public-health costs in sub-Saharan Africa, and the severe flu-like symptoms keep adults out of the workforce. WHO estimates that, had malaria been eradicated from sub-Saharan Africa 35 years ago, the region’s gross domestic product would be $100 billion richer.

Putting RTS,S into practice will cost about $500 million, according to Christian Loucq, director of the PATH Malaria Vaccine Initiative, funded largely by the Bill and Melinda Gates Foundation. In preparation for the large-scale trials, GSK and PATH have upgraded several pediatric wards in hospitals, equipping each with microscopes for testing blood samples and satellite networks to quickly share data. Meanwhile, a Harvard University research group will monitor the vaccine to make sure it works on all substrains of the parasite.

While several scientists continue to work on stopping malaria before it bites—either by killing mosquitoes before they transmit the parasite or destroying their breeding grounds—Loucq says RTS,S offers the best chance of reaching the United Nations’s Millennium Development Goal to stop the disease’s upward trend by 2015. “Vaccines for infectious diseases like polio and tuberculosis changed the picture entirely,” he says. “A 53 percent efficacy rate for a first-time vaccine puts us on the way to victory

Previous Article: Does Hollywood Really Need to Get the Science Right?

Next Article: Faster Than a Speeding Songbird

Want to learn more about breakthroughs in electronics, medicine, nanotech, and more?
Subscribe to Popular Science and enter to win $5,000!

6 Comments

link to this comment

jarstar1

02/17/09 at 3:07 pm

This is very much needed, and it's a good thing it is getting started. the faster the better.

link to this comment

khrhee91

02/19/09 at 4:18 pm

Living in Tanzania all my life I have seen the impact of this disease.

The availability of the cure (not vaccine) is widespread as most hospitals and pharmacy's in the country (especially in the up-scale city of Dar-es-Salaam which I currently reside) have a readily available supply of Malaria tablets which cure the disease usually with the 3 days worth of pills. (mostly 3 tablets a day; effects are usually seen from the next day) And living in this country I have been contacted by this disease more than 10 times, but with these tablets I have been able to easily recover from each episode. (and so have countless others by these proven tablets)

So why are many children dying in Africa by this disease?-the meager price that doesn't exceed $10 can't be afforded by families or many families can't afford even the $1-3 for testing of their children(which seem absurd to expats-like myself and citizens of foreign countries such as the US). A hope of optimism comes before me as I read this article but I stumble upon a question- if the vaccines are needed to be paid for, would many families in rural areas be able to afford it? Relating to the issue:there is usually not a free national vaccine service and many families are not aware of vaccinations. Lastly, many foreign funding may be dissolved into the depths of corrupt governments.

But I still have optimism and believe this could be a large step forward in saving hundreds(thousands, millions!) of children with this new breakthrough; given that the variables are fully dealt with as well.

link to this comment

dodah

02/26/09 at 8:43 pm

First off; if, you are living in a designated part of Tanzania with a Malaria alert...you are most likely being bitten; and, getting the malaria disease many times 'per' year. If,the case: You have built up an enmity to the symptoms, while still having the disease. Which means, you remain a target for transfer of the disease to other people, in your malaria (Anafolice)alert area?
You are probably taking the malaria treatment drugs like aspirin...if; you were to track the truth.
The malaria drug cost in Africa, is not the 'big' problem...!

"The Anopheles Mosquito" is; and,(as of this date) continues to deify all odds of drugs that "PREVENT" malaria. It even defies drugs that "TREAT" malaria.

They (Anafolice) might faultier in early stages of drug prevention development, but, soon after its game over... (Very unfortunate; primarily babies.)

This is the big picture: The "babies"..."small children"..."pregnant mother's" once bitten (get;"the disease")travels to the heart, and more rapidly to the brain...somehow, they are dead via "early" transmission-bites from the Anopheles. They(babies)have little or 'no' an-amenity build-up to become well or healed "fast" enough from the drug treatment programs.(even if free)It is why; if, you notice the exploratory drug "prevention" treatment is being conducted on younger children. The global health-world (after 37 long year’s) is keen to the use of DDT “indoor residual spraying" (once more) and, use of "treated bed nets". So: any drug miracle(s)should be with continued use of both indoor wall spraying & nets; for ten years or more beyond satisfactory-conclusive-positive results. Based (solely)on history.

You-as an adult person can continue taking malaria drugs like aspirin & risk side effects…”but”, not the kids-babies with no rights of protection, and or life, as a choice.

link to this comment

Echte Wahrheit

03/10/09 at 10:53 pm

The success of the RTS,S malaria vaccine arises from its co-development by the Walter Reed Army Institute of Research with GlaxoSmithKline for the last 25 years. The first and every successive improved version of the RTS,S vaccine was carefully tested under strict FDA guidelines with the U.S. Army as a joint effort. The success now of the RTS,S malaria vaccine is a brilliant result of the American military collaborating with industrie to develop vaccines, other examples being the first vaccines ever for hepatitis A and japanese encephalitis.

link to this comment

cooleo

03/16/09 at 6:06 pm

wow this is the best ever ever ever. even if it only helps 53 percent that was a 53 percent earler we did not have. it is sickning though being a 5 year old playing and dying at the same moment just because a mosquitto bit you and you never noticed. having your red blood cells burst and your liver attacked while you go in chills and in a fever adn mom and dad have no clue i am so glad we can at least help 53 percent 53 percent is amazing

link to this comment

khrhee91

05/01/09 at 4:48 pm

To: Dodah
I would just like to clear a few things.
Firstly, malaria is a parasite called protozoan that can be eradicated.

I would like to challenge your statement of

""The Anopheles Mosquito" is; and,(as of this date) continues to deify all odds of drugs that "PREVENT" malaria. It even defies drugs that "TREAT" malaria."

Are you stating that we can't be treated of malaria or that they mutate to be resistant to drugs? Mutations are combated with medical improvements on the drug, similarly with every other disease.Malaria can be cured by prescription drugs and a correct dosage. And yes, you can be CURED by the disease and not necessarily carry the disease as you say. The CDC states "However, in general, if you are correctly treated for malaria, the parasites are eliminated and you are no longer infected with malaria."

Yes, they can be dormant by parasites(total of 4 types) such as Plasmodium vivax and P. ovale and stay in places such as your liver and I believe blood vessel for long periods of time. But these parasites can be differently identified by doctors and given medication to stop the relapses, but these are also rare cases.

You stated that I am a target for the transfer of the disease, I do not believe so if I don't carry the parasite and human to human transfers are non-existent(in my understanding and in medical journals that I have reviewed)

I totally agree with you in the comment of "So: any drug miracle(s)should be with continued use of both indoor wall spraying & nets". My father has a fumigation project and I am in favor of his project.It seemed as if you hinted that "babies"..."small children"..."pregnant mother's" have no chance at all with the treatments. But have seen small children, babies, and pregnant mothers be treated. It gets especially complicated with pregnant mothers and babies but I believe treatment is available. My first impressions were that you believe children have no hope after getting the disease.

If you would read my comment again, I am not against the vaccine, but very glad about it! But changes are needed to give maximum impact or any impact at all. Médecins Sans Frontières estimates that the cost of treating a malaria-infected person in an endemic country was between US$0.25 and $2.40 per dose in 2002. I assume the vaccine would be more expensive and lack of education would further deter the expansion of the vaccine.

I would love to hear about a article that backs up your argument of:

"The Anopheles Mosquito" is; and,(as of this date) continues to deify all odds of drugs that "PREVENT" malaria. It even defies drugs that "TREAT" malaria."

"They(babies)have little or 'no' an-amenity build-up to become well or healed "fast" enough from the drug treatment programs." are you saying all of them have no hope?

I would love to be corrected!

P.S I am actually not a "adult person". I am legally not a adult..