For the last 70 years, several research projects on a potential Malaria vaccine have been launched and executed at a cost of millions of dollars, but without any breakthrough. However, efforts seem to have been doubled in recent years, raising hopes of a remedy against a disease that annually claims over 600,000 people worldwide, most of them Africans. About two weeks ago, global pharmaceutical company GlaxoSmithKline announced it had submitted its first regulatory application to the European Medicines Agency (EMA) and World Health Organisation for the assessment of the RTS,S, a new Malaria vaccine. The company is optimistic that if approved, the vaccine will hit the market by next year. “This is a key moment in GSK’s 30-year journey to develop RTS,S and brings us a step closer to making available the world’s first vaccine that can help protect children in Africa from Malaria,” Sophie Biernaux, head of GSK’s Malaria vaccine franchise said in the statement. GSK says their vaccine will be not-for-profit - but it will add 5 per cent to the cost price which will go towards further research and development work on tropical diseases. The pharmaceutical giant spent $350 million on the vaccine as of August 2013 and expected to invest $260 million more before it can be rolled out. The Bill and Melinda Gates Foundation also put in $200m. If endorsed, the project has the potential to prevent up to 100 million cases of the disease each year and save 200,000 lives. A number of similar trials are also on–going elsewhere. In May this year, a team of scientists at Brown University, US, discovered an antibody that halts the progress of Malaria by caging its parasites in red blood cells. The vaccine trial carried out on rodents, found that those that had been vaccinated lived almost twice as long as the unvaccinated ones and had far lower levels of Malaria parasites. “We are trying to develop a Malaria vaccine that prevents the parasite from entering the red blood cell. We have now found a way to block it from leaving the cell once it has entered and once it is trapped there, it cannot do any further damage,” noted Jonathan Kurtis, an immunologist and leader of the team of scientists. Similar trials are yet to be carried out on monkeys and then later humans. In late 2013, the, PfSPZ, a vaccine candidate developed by the National Institute of Allergy and Infectious Diseases in Bethesda, Maryland U.S.A, showed promising results, after the six subjects given five doses by injection were 100 percent protected from infectious mosquitoes, whereas five of six unvaccinated people developed Malaria — as well as the three of the nine people given only four doses of the vaccine. In August 2013, another vaccine, made by Sanaria, a company based in Maryland, USA still, protected six volunteers who each got five doses for 20 weeks. It provided them with 100 per cent protection against infection during tests, it is yet to be tried in Malaria prone areas like sub-Saharan Africa and parts of Asia. The success of the above developments will be a crucial step in helping achieve WHO’s target of developing a Malaria vaccine which has an efficacy of at least 80 percent by 2025. Local experts react Dr. Olivier Manzi, a specialist in infectious diseases at the University Teaching Hospital of Kigali (CHUK) expressed optimism that the discovery of a vaccine would bring down the prevalence of Malaria in hardest hit districts, for instance Nyagatare that topped countrywide with 40.4 percent in 2011. “In the adult wing alone we register about 100 cases of Malaria monthly, we hope that number would go down with the discovery of a vaccine,” he remarked. However, Alpha Uwimana, another infectious diseases specialist working with Pharma Clinic in Gikondo, a Kigali suburb, had a different view. “I have studied most researches on those vaccines, but they seem to show more effectiveness among children than adults, so we might still need to keep the traditional approaches for fighting malaria, even after the vaccine is introduced,” he said. In May the government unveiled a new strategic plan to end Malaria deaths in the country by 2018, dedicating about $329 million (about Rwf223 billion) to it. Aspects of the strategic plan include rapid testing and treatment by community health workers within 24 hours of a patient showing signs of Malaria, and monitoring by the Rwanda Biomedical Centre (RBC). “Scaling up of interventions, over the years, has made significant reductions in morbidity by 87 per cent from 1,669,614 cases in 2005 to 212,200 in 2011, and reduced mortality by 76 per cent from 1,582 deaths in 2005 to 380 death in 2011,” said Dr. Corine Karema, the head of Malaria and other Parasitic Diseases at RBC. The Demography and Health Survey 2010 report showed that 83 per cent of households nationwide own at least one mosquito net and 82 per cent own at least one insecticide-treated net (ITN), compared to 18 per cent in 2005 and six per cent in 2000. The report also showed that 71 per cent of children under the age of five slept under a mosquito net in 2010, compared to 10 per cent in 2000. “Rwanda has since then achieved over 90 per cent laboratory confirmation of Malaria cases before treatment, compared to 40 per cent in 2005. In 2010, the rate of Malaria cases treated after laboratory confirmation was 94% and is 99% as at 2012,” Karema said in an earlier interview. Prevalence About 900,000 Malaria cases were registered in 2013 and 409 people died as a result of the disease with 30 per cent of them being children under the age of five, according to information from the health ministry. In East Africa, some 16 million to 18 million Malaria cases are reported every year. According to the WHO, malaria killed 627, 000 people in 2012, most of them children in sub-Saharan Africa. Rwanda is among seven African countries that were recognised for exceptional progress in scaling up malaria control interventions by the African Leaders Malaria Alliance (ALMA) award in January this year.
