A potential breakthrough in malaria vaccines

Malaria affects millions of people every year in the tropics, and the majority of the deaths from the disease are in young children. It's one of those diseases that's been crying out for a vaccine for decades, but it's proved a difficult nut to crack. The malaria parasite has a complex life cycle and thousands of genes making it hard to disentangle how it works and best to target it. But, this month, UNICEF have awarded a contract worth nearly 200 million Dollars to drug giants GSK to make millions of doses of a promising new vaccine candidate called RTS, which will be supplied for children at risk in the key malaria hotspots. Mary Hamel leads the Malaria Vaccine Team at the World Health Organisation…

Mary - This vaccine is made up of a protein and what's called an adjuvant, something that stimulates the immune system to work a little better. The vaccine targets the very first stage of the malaria parasite. When the female mosquito injects the parasite into the human host, the vaccine stimulates the immune system to make antibodies against the parasite so that the disease does not progress.

Chris - And how effective is it?

Mary - The phase three trials showed that the vaccine could reduce malaria in young children by over half and severe malaria by about the same. Now we're used to hearing about vaccines that are 90% efficacious, but when you have a disease like malaria, where children can have malaria infections 6, 7, 8 times per year, until they build up their acquired immunity, they're at risk of progressing to severe malaria and death. Reducing those cases by 50% can really be substantial.

Chris - Yeah. I was going to say with a disease that's killing up to a million people a year. 50% of that is still a massive saving of lives, isn't it?

Mary - That's exactly right. And we've seen just this in the pilot implementations

Chris - And this present announcement is an award of a large tranche of funding to get those vaccines manufactured and then out there into the field.

Mary - That's right. This is really a major milestone. Right now over a million children have benefited from the vaccine in the pilot programs in Malawi, Kenya, and Ghana. This award, and this contract between UNICEF and the manufacturer, means that millions more children will benefit in other countries. There can be expansion, but there is a challenge here. And that is that the demand for this vaccine is very high. There are more than 25 million children who live in these areas of high risk for malaria and severe malaria. And that means that at a steady state, it's estimated that over 80 million doses of vaccine will be needed each year. So this is a challenge that WHO, GAVI, and other partners are working on now as a priority. There's what's called a market shaping team that's working specifically to find ways to increase supply and decrease cost so that this vaccine can reach all these children who are living at risk.

Chris - So where do you see the numbers going once this money starts to flow? Once these vaccines start to make their way into the field, if we have this conversation in five years time, and you're looking back, what will you say happened since?

Mary - I think what we will be seeing five years from now is that there's more than one vaccine available, that prices come down substantially, that the global health architecture that was put in place to support vaccines reaching these children who are living in these areas of high need, that it has been successful, and that continues with a major impact in child deaths.