Closer than ever to a malaria vaccine

On the eve of the 8th World Malaria Day, recognized on April 25th, there was an announcement in the British medical journal The Lancet of a major step forward in the development of a malaria vaccine. As a result, a malaria vaccine known as RTS,S, developed over the course of two decades by drugmaker GlaxoSmithKline with the help of funding from the Bill & Melinda Gates Foundation could be approved for use in Africa by the World Health Organization (WHO) as early as October of this year.

According to the clinical trial findings, RTS,S may have the capability to prevent millions of cases of malaria, especially in young children who are incredibly susceptible to the parasitic disease. Studies from 2011 and 2012 dampened optimism about this malaria treatment as the vaccine stopped malaria episodes in less than half of those children younger than two years of age that received it. However, follow-up data included in the Lancet piece showed that, when a booster shot was applied, a total of 1,774 cases of malaria were prevented per 1,000 vaccinations. Without a booster, the vaccination still prevented 1,363 malaria cases.

Still, this vaccine won’t be the only answer in the global fight against malaria, a disease that infected 198 million people worldwide and killed about 584,000 people during 2013 according to the WHO. In that year, 90 percent of all deaths occurred in Africa and most of those were young children, highlighting the need to apply preventative medicine techniques early in a child’s life. After four years, the effectiveness of the RTS,S vaccine drops to about 36 percent, even when regularly scheduled vaccine boosters have been administered. Most plans for implementation of this vaccine also involve the application of insecticide-treated bednets and anti-malarial drugs.

Anyone who has followed the global struggle to develop a preventative vaccine for malaria will realize the major step that this discovery constitutes. Malaria is very difficult to treat because of the complexity of Plasmodium falciparum protozoan parasite that causes the disease. Between 2000 and 2013, malaria mortality rates dropped by 47 percent, with scale-up malaria interventions being hailed as the major reason why 4.2 million lives were saved in that time. Still, with 3.2 billion people at risk of developing malaria, developing a cure for malaria will continue to be a major undertaking for the pharmaceutical sciences.

We’ve seen the painstakingly slow struggle to develop effective treatments for the world’s most dangerous diseases play out a couple of times now in the history of modern medicine. It is impossible to understate the role of vaccinations in eliminating many of these ailments from our contemporary consciousness, at least here in America. An infographic published by Forbes shows how diptheria, polio and smallpox have been completely eradicated by their respective vaccines. Another six diseases, including rubella and the mumps, have been at least 98 percent eradicated in our country, compared to pre-vaccination patient numbers.

International travel is one way that many of these diseases are allowed to cross borders and take root all over the world, even in places where they were thought to be non-existent. The recent measles outbreak occurring in the United States has its beginnings in a measles strain that made it to our country from the Philippines, according to the U.S. Centers for Disease Control. The CDC recommends international travelers to be up to date on their vaccines, completing any vaccination series from four to six weeks before travel to ensure that a recipient’s body has had a chance to build an immunity.

Much has been made in recent years of the activities of the anti-vaccination crowd and its troubling effects on public health here in America. For one, herd immunity is absolutely real and it requires everyone who comes into contact with each other to have been vaccinated. A paper co-authored by a couple of professors from the University of Michigan indicates that herd immunity, a situation in which a large enough portion of a populace is inoculated against a disease that the entire population is sufficiently immunized, requires anywhere from 85 percent to 95 percent immunization rates.

Although the anti-vaccination movement is troubling, it’s not new. The University of Michigan paper pointed out how protests over vaccinations in America and Europe date back to the 1830s, decades after the first smallpox immunization techniques were developed. The costs of treating patients who have contracted a disease and the high rates of immunization needed for herd immunity, however, have caused many to wonder whether vaccination should be compulsory for children in our country. Vaccines are incredibly cost-effective; many single vaccine doses for diseases like meningitis, hepatitis B and measles cost less than a dollar, and the rotavirus vaccine is only $3.50 per dose. If all of the American children born in 2009 were properly immunized, those vaccinations will contribute to a total lifetime savings in health treatment costs of $13.5 billion in healthcare costs alone, not to mention lost productivity. Preventing a disease will always be cheaper than trying to stop it once it has gained a foothold in a patient.