How big a difference will the world's first malaria vaccine make?

By 2015, GlaxoSmithKline hopes to market the world's first malaria vaccine. But a lot more needs to be done to tackle a disease that kills 660,000 people a year.

The UK company GlaxoSmithKline is hoping that by 2015 it will be able to introduce the world’s first malaria vaccine. In clinical trials, the vaccine halved the number of cases of malaria in babies aged five to seven months, and reduced by a quarter the number of cases in babies aged six to twelve weeks. This means it isn’t a miracle cure for the mosquito-borne disease that WHO estimates kills 660,000 people a year, but it could still make a huge difference – malaria is the fifth biggest killer of under-fives globally.

There are still obstacles to overcome before the vaccine can be introduced. It will need to be approved by health regulators, international donors will have to agree to fund the vaccine, and WHO will have to co-ordinate a plan for rolling-out vaccination programmes.

In 2004 a group of malaria experts wrote a damning report in the medical journal, Lancet, accusing WHO of contributing to unnecessary malaria deaths because of its slowness to replace failing malaria drugs with newer more effective treatments. The hope is that WHO has taken these criticisms on board and has become nimbler and more responsive to change. But while researching an article on drug-resistant malaria, a number of experts told me they were frustrated with WHO’s slow and unwieldy bureaucracy. “WHO, like any other UN organisation, has enormous problems. It’s primarily a political organisation, not a technical organisation, and it’s basically shown weak leadership in recent years, in many areas,” Dr Nick White, chairman of the Mahidol Oxford Tropical Medicine Research Unit in Bangkok, told me.

There is also hope that this latest discovery will pave the way for the development of more effective malaria vaccinations, but researchers often find that funding is hard to come by. Selling anti-malarials to the poor isn’t especially lucrative for drug companies – and in fact, globally, more money is spent on treating male baldness than malaria.

There’s a new urgency to this work to develop a vaccine too, because in parts of South East Asia, malaria is becoming resistance to artemisinin, the most effective anti-malarial drug to date. Experts at the World Malaria Conference 2012 predicted that if artemisinin resistance spreads to Africa, where the incidence of malaria is much higher, global malaria deaths will increase by 25%. NGOs and governments in South East Asia are doing their best to contain drug resistance, by increasing the use of mosquito nets and improving access to high-quality malaria drugs. The recent discovery of drug-resistant malaria on the Thai-Burma border, however, suggests that drug-resistant malaria is spreading despite containment efforts.

If drug-resistant malaria continues to spread in this way, developing an effective vaccine for malaria might be our best bet. GlaxoSmithKline’s discovery is a big step forward, but without sufficient political will and funding, we could still lose the battle against malaria.

A laboratory technician prepares blood samples to test for malaria. Photo:Getty.

Sophie McBain is a freelance writer based in Cairo. She was previously an assistant editor at the New Statesman.

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"We repealed, then forgot": the long shadow of Section 28 homophobia

Why are deeply conservative views about the "promotion" of homosexuality still being reiterated to Scottish school pupils? 

Grim stories of LGBTI children being bullied in school are all too common. But one which emerged over the weekend garnered particular attention - because of the echoes of the infamous Section 28, nearly two decades after it was scrapped.

A 16-year-old pupil of a West Lothian school, who does not wish to be named, told Pink News that staff asked him to remove his small rainbow pride badge because, though they had "no problem" with his sexuality, it was not appropriate to "promote it" in school. It's a blast from the past - the rules against "promoting" homosexuality were repealed in 2000 in Scotland, but the long legacy of Section 28 seems hard to shake off. 

The local authority responsible said in a statement that non-school related badges are not permitted on uniforms, and says it is "committed to equal rights for LGBT people". 

The small badge depicted a rainbow-striped heart, which the pupil said he had brought back from the Edinburgh Pride march the previous weekend. He reportedly "no longer feels comfortable going to school", and said homophobia from staff members felt "much more scar[y] than when I encountered the same from other pupils". 

At a time when four Scottish party leaders are gay, and the new Westminster parliament included a record number of LGBTQ MPs, the political world is making progress in promoting equality. But education, it seems, has not kept up. According to research from LGBT rights campaigners Stonewall, 40 per cent of LGBT pupils across the UK reported being taught nothing about LGBT issues at school. Among trans students, 44 per cent said school staff didn’t know what "trans" even means.

The need for teacher training and curriculum reform is at the top of campaigners' agendas. "We're disappointed but not surprised by this example," says Jordan Daly, the co-founder of Time for Inclusive Education [TIE]. His grassroots campaign focuses on making politicians and wider society aware of the reality LGBTI school students in Scotland face. "We're in schools on a monthly basis, so we know this is by no means an isolated incident." 

Studies have repeatedly shown a startling level of self-harm and mental illness reported by LGBTI school students. Trans students are particularly at risk. In 2015, Daly and colleagues began a tour of schools. Shocking stories included one in which a teacher singled out a trans pupils for ridicule in front of the class. More commonly, though, staff told them the same story: we just don't know what we're allowed to say about gay relationships. 

This is the point, according to Daly - retraining, or rather the lack of it. For some of those teachers trained during the 1980s and 1990s, when Section 28 prevented local authorities from "promoting homosexuality", confusion still reigns about what they can and cannot teach - or even mention in front of their pupils. 

The infamous clause was specific in its homophobia: the "acceptability of homosexuality as a pretended family relationship" could not be mentioned in schools. But it's been 17 years since the clause was repealed in Scotland - indeed, it was one of the very first acts of the new Scottish Parliament (the rest of the UK followed suit three years later). Why are we still hearing this archaic language? 

"We repealed, we clapped and cheered, and then we just forgot," Daly says. After the bitter campaign in Scotland, in which an alliance of churches led by millionaire businessman Brian Souter poured money into "Keeping the Clause", the government was pleased with its victory, which seemed to establish Holyrood as a progressive political space early on in the life of the parliament. But without updating the curriculum or retraining teaching staff, Daly argues, it left a "massive vacuum" of uncertainty. 

The Stonewall research suggests a similar confusion is likely across the UK. Daly doesn't believe the situation in Scotland is notably worse than in England, and disputes the oft-cited allegation that the issue is somehow worse in Scotland's denominational schools. Homophobia may be "wrapped up in the language of religious belief" in certain schools, he says, but it's "just as much of a problem elsewhere. The TIE campaign doesn't have different strategies for different schools." 

After initial disappointments - their thousands-strong petition to change the curriculum was thrown out by parliament in 2016 - the campaign has won the support of leaders such as Nicola Sturgeon and Kezia Dugdale, and recently, the backing of a majority of MSPs. The Scottish government has set up a working group, and promised a national strategy. 

But for Daly, who himself struggled at a young age with his sexuality and society's failure to accept it, the matter remains an urgent one.  At just 21, he can reel off countless painful stories of young LGBTI students - some of which end in tragedy. One of the saddest elements of the story from St Kentigern's is that the pupil claimed his school was the safest place he had to express his identity, because he was not out at home. Perhaps for a gay pupil in ten years time, that will be a guarantee. 

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