The world continues to tremble from the devastating deaths caused by COVID-19. More than 2.2 million people have been infected and about 180,000 people have died worldwide.
As of April 23, European nations top the global death toll from the new coronavirus. In the same period, 1,199 virus-related deaths have been reported in Africa.
Meanwhile, Africa has continued to live with the heavy burden of malaria – a far more deadly disease that plagued African communities for centuries. In 2018 alone, in Sub-Saharan Africa, 405,000 people died from malaria, report the Centers for Disease Control.
Malaria is avoidable and curable, but with a tropical climate responsible for its transmission throughout the year- – exacerbated by poor socioeconomic conditions – makes it difficult to effectively control and treat cases of this disease.
Now a new malaria vaccine called Mosquirix offers hope to communities in Africa that have been fighting evil for years.
Malaria, a murderer of women and children
Malaria, a tropical disease transmitted by the female Anopheles mosquito, is caused by the parasite plasmodium falciparum. Typical symptoms are fever, fatigue, vomiting, and body aches.
Every minute, in many African nations a child dies from this disease; of every 10 patients, nine do not survive according to the World Health Organization (WHO).
Most malaria-related deaths are from pregnant women and children. The United Nations Children's Fund (UNICEF) states that every two minutes a child under the age of five dies from malaria – which means that 730 children die daily from the disease.
Sub-Saharan Africa and India are the most affected by malaria with 85% of cases in 2018. Furthermore, the WHO states that these six African nations represent more than 50% of the total malaria cases in the world: “Nigeria (25%) , Democratic Republic of the Congo (12%), Uganda (5%), Ivory Coast, Mozambique and Nigeria (4% each) ”.
In 2018, sub-Saharan African nations spent more than $ 12 billion on managing malaria cases, according to UNICEF.
Vaccine against malaria
Mosquirix —also known by the scientific name RTS.S— is a “pre-erythrocyte” vaccine for malaria, which refers to the phase of transmission of the disease before the victim manifests the clinical symptoms that normally manifest in that phase. , according to a study by Ashley M. Vaughan and two other colleagues at the Seattle Biomedical Research Institute in Washington state, United States.
The idea is for the RTS.S to “activate the immune system to defend against the first phase” when the parasite enters the blood stream after being bitten by an infected mosquito.
The surface of the malaria parasite (plasmodium falciparum) contains a protein or antigen that causes the body's immune system to make antibodies. Mosquirix, an attenuated form of the parasite, causes the same reaction in the body, and thus produces the antibodies that fight malaria, according to a 2004 investigation conducted by a team of experts led by Dr. Pedro L. Alonso of the International Health Center, Clinical Hospital, Barcelona, Spain.
Scientists working with the British pharmaceutical laboratory GlaxoSmithKline created the vaccine in 1987. The first clinical trials were conducted in 1995 with adult volunteers living in the United States and Belgium. In 1998, the vaccine was tested on adult volunteers in The Gambia.
The second series of clinical trials was carried out between 2004 and 2007 in Mozambique. 2,022 children between the ages of 1 and 4 participated in the 2004 trial, while 214 children participated in the 2007 randomized trials.
The third series started in May 2009 and ended in early 2014 with the participation of 15,459 children from seven African countries: Burkina Faso, Gabon, Ghana, Kenya, Malawi, Mozambique and Tanzania.
The WHO launched the first RTS.S pilot study in Malaii, followed by Ghana and Kenya in April 2019.
Following the results of the third series of trials, Professor Peter Aaby of the Bandim Health Project in Guinea-Bissau and four other colleagues identified three safety concerns with the RTS.S vaccine: “high risk of meningitis, cerebral malaria and duplication of female deaths ”.
Aaby and colleagues recommended that the 'pilot application' of vaccine research started in 2019 use 'overall mortality' to assess the performance of that vaccine and that 'populations studied be tracked over the four to five years of the study before making an application decision. ”
However, in January 2016, the WHO reported that it had already recommended further testing of RTS.S in a “series of pilot applications” with the aim of “addressing knowledge gaps” before the safety of the company was certified. vaccine for the general public.
Pilot application of the vaccine
Kenya Health Minister Sicily Kariuki, at the start of the pilot application of the RTS.S on September 13, 2019, stated that the vaccine will be used in counties where “the highest burden of malaria is more than 20%” , specifically: Kakamega, Vihiga, Bungoma, Busia, Kisumu, Homa Bay, Migori and Siaya.
The Odede Health Center, located in Siaya County, is one of the rural hospitals chosen by the Ministry of Health to apply the experimental vaccine in Kenya.
Gabriella Ocenasek of World Youth International, an Australian non-governmental organization, informed Global Voices in a press release that the vaccine is administered three times to children aged six, seven and nine months, and is repeated after two years. As of March 2020, more than 250 children had received the vaccine at the health center.
A mother expressed her initial fears that her son “would react to vaccines”:
When I brought John in for his first jab, I feared he was going to react to the vaccines as many people had believed, but he took it well and he never cried or fell sick due to the vaccine. I have been letting my community know that this is good for our children, everyone needs it.
When I brought John for his first injection, I was afraid he would react to vaccines as many people had believed, but he took it well, did not cry, and did not feel bad after the puncture. I want my community to know that it is good for our children, everyone needs it.
Despite this, the WHO has not yet approved the public use of the vaccine. This will depend on the results that emerge after this phase of experimental application.
If the results are positive without debilitating side effects, the RTS.S vaccine will be the key to dramatically reducing malaria-related infant mortality.
It will be a radical change in malaria management in sub-Saharan Africa, a region affected by this scourge for centuries.