|In 2017 there were an estimated 219 million cases of malaria, 92% of which occurred in Africa / Phot by Getty Images|
Malaria is a serious disease that can be fatal, but the first steps to eradicating it have finally been taken. Two days before World Malaria Day (April 25), the pilot launch for the malaria vaccine was conducted in Malawi. Malawi will be the first of three countries in Africa to roll out the monumental vaccine followed by Ghana and Kenya. The vaccine will hopefully immunize many people who are at risk of contracting malaria in high-risk areas.
Malaria is a parasitic disease that is usually transmitted by mosquitoes. The World Health Organization (WHO) releases regular reports detailing the effects of malaria worldwide. The most common parasite that causes malaria is Plasmodium falciparum, which caused about 99.7% of the cases in Africa in 2017, as well as in many other countries from other regions, such as Southeast Asia (62.8%), the Eastern Mediterranean (69%), and the Western Pacific (71.9%). In the Americas, 74.1% of malaria cases are caused by the Plasmodium vivax (p. vivax) parasite, which acts as the main instigator.
In 2017 there were an estimated 219 million cases of malaria, 92% (around 200 million) of which occurred in Africa. The death count caused by the disease was about 435,000 in 2017, most of whom were children. Those under 5 years old are the most susceptible to the life-threatening complications that are brought about by malaria and they account for 61% of malaria deaths.
The African region was chosen to pilot test the vaccine as most of the high-burden countries are located there. Just 11 countries account for 70% of malaria cases, made up of 10 sub-Saharan countries and India.
Current Efforts against Malaria
Prevention of malaria is mostly focused on controlling mosquitoes that are the main transmission method for the malaria-inducing parasites. Insecticide-treated mosquito nets (ITN) are the main defense against the deadly insects especially those who are high risk. Low-risk households conduct indoor residual sprayings (IRS), which involves spraying the inside of walls with insecticide. Although effective, there are signs showing that resistance to the insecticides is starting to appear.
Another prevention method employed is called intermittent preventive treatment in pregnancy (IPTp) that entails treating pregnant women with an anti-malarial drug called sulfadoxine-pyrimethamine. Only 22% of eligible pregnant women received this treatment while only 15.7 million children (out of 29.3 million) were able to take another prevention method called seasonal malaria chemoprevention (SMC).
Artemisinin-based combination therapy (ACT) is currently the treatment being used to combat the disease on infected patients. This method is basically the administration of various anti-malarial drugs with high efficacy to quickly remove the parasite. Fast-acting and high-efficacy methods are important to lessen the chances of the parasite mutating to resist existing drugs. These drugs need to be consistently improved as the parasites constantly build resistance to existing drugs.
The Vaccination Program
The pilot vaccination program is a partnership of various parties from both the public and private sectors and coordinated by the World Health Organization. In addition to the health ministries of the three involved countries, there were many domestic and international groups including the non-profit organization PATH and the developers of the vaccine, GSK (GlaxoSmithKline). GSK donated 10 million doses of the vaccine to be used in the pilot program. In 2017, a total of US$3.1 billion was donated to the efforts to fight against malaria. The Global Fund to Fight AIDS, Tuberculosis, and Malaria organization handle the majority of donations, up to a third of the total donations. More recently the Bill and Melinda Gates Foundation has also been donating to the development of the vaccine.
Commonly referred to as RTS,S, it is a protein-based malaria vaccine, the first of its kinds in the world. The vaccine was in development for 30 years and it was finally approved for use in 2015 by European authorities. With the approval for the use of the vaccine, WHO proposed the pilot launch, as the organization has lead to the implementation we see today. During clinical trials, the success rate was only 40% of most malaria cases and 30% for severe cases. Although the success rates are not very high, millions of cases can still be prevented. For now, it is intended to complement current prevention techniques as it is currently unable to completely cure the disease.
|Prevention of malaria is mostly focused on controlling mosquitoes that are the main transmission method for the malaria-inducing parasites / Photo by Getty Images|
Malaria is still a very serious disease that kills almost half a million people annually. The African region is the most heavily afflicted with the disease and although there are some prevention techniques employed, due to poverty, much of the population are unable to put them to practice. While somewhat effective, the best way to combat malaria is to use as much of the available tools for prevention and not just rely on one method. The development and administration of the RTS,S vaccine brings with it the hope that one day the disease will be eradicated as the use of the vaccine becomes more widespread and its efficacy improved.