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.
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