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Malaria Vaccine Passes Key Regulatory Hurdle
An anonymous reader writes: The BBC reports that the European Medicines Agency has approved the world's first malaria vaccine for real-world use. The vaccine is far from perfect, and the World Health Organization still has to make a final decision on it, but it's a key victory for GlaxoSmithKline, who have been developing the vaccine for three decades. "The best protection was among children aged five to 17 months who received three doses of the vaccine a month apart, plus a booster dose at 20 months. In this group, cases of severe malaria were cut by a third over four years." Unfortunately, the boosters are quite necessary for protection, and it doesn't protect young babies from malaria. The disease "kills around 584,000 people a year worldwide, most of them children under five in sub-Saharan Africa."
Malaria in humans is caused by five different species of plasmodium parasites. That they could get a vaccination at all effective is wonderful and surprising.
Prof Adrian Hill of the Jenner Institute, Oxford, said he was pleased and encouraged by the EMA's decision but added that the vaccine was not a "magic bullet".
He said: "A bed net is more effective than this vaccine, but nonetheless it is a very significant scientific achievement.
While research into a vaccine is great, why haven't we focused efforts on supplying bed nets for everyone? I'm assuming that they'll cost less than the vaccine per unit and they also have the advantage of being reused.
Even a vaccine that just reduces the devastation this disease causes is a huge win. The impact of this disease on affected areas is almost impossible to over state. Cutting the number of cases by a third is still hundreds of thousands of lives saved.
The key problem with this vaccine is that it only reduces a child's chance of getting malaria by one-third. That benefit could easily be negated if being vaccinated causes parents to not be a cautious as they would be otherwise, such as less like to use anti-mosquito nets at night.
It's a well-know effect. Increasing safety on on area can result in less care being taken in others and consequently more bad results rather than less.
While research into a vaccine is great, why haven't we focused efforts on supplying bed nets for everyone?
Because bed nets merely mitigate the problem, not solve it. Bed nets are a good thing but they are merely a stopgap and nobody can live inside them at all times. Mosquitoes don't just bite at night when you are in bed. Anyway there are groups (including the CDC and WHO) who have spent considerable effort and money distributing bed nets.
I'm assuming that they'll cost less than the vaccine per unit and they also have the advantage of being reused.
Would you rather sleep under a bed net for your entire life or would you rather be vaccinated and not have to worry so much about the disease?
Why aren't the locals buying bed nets themselves?
A variety of reasons. In places nearly half the population refuses to sleep under them. Sleeping under one is hotter than without and in some places this can matter. The nets sometimes get mis-used (like as fishing nets). Some people don't believe that the mosquito is the cause or the only cause. They are (rightly) seen as uncomfortable to use and provide only partial protection at best. Sometimes people don't trust the folks handing them out. They also eventually wear out.
I know we're talking about very poor people but that sounds like somewhere where'd I'd expect a local industry to pop up.
The problem is less getting the people the bed nets, it is getting people to use them. Think about it this way. Here in the US we have a flu vaccine available very inexpensively (often free) each year which provides partial protection against influenza viruses. Thousands of young and elderly people die from this disease each year. And yet many refuse to get the vaccine for a variety of mostly social reasons. It's basically the same phenomena.
Yay for vaccine, some day, even for infants.
Yay for FREE mosquito nets.
But you do realize however... these are measures that we --- the countries who have already eradicated Malaria --- would not tolerate, if WE were as affected as they?
THE WHITEWASHED VERSION OF HISTORY
You're living it. Most people have no real perspective on DDT at all, it is simply something evil which allowed persons in developed countries which had already eradicated Malaria to claim its discontinuance as "the greatest environmental victory for everybody, ever"... though actually, taking lead out of gasoline was the real greatest victory. Most are too zero-tolerance enviro-Puritan even to consider a distinction between a light regimen of spraying walls inside homes versus the (mind bogglingly huge) agricultural applications throughout North America up to 1972, which everyone agrees was a bad idea. DDT is simply some 'evil banned substance'. Anyone talking about it is a loon. Anyone asking, where could they possibly get some is a subversive. It has come to this. That is the extent of this modern ugly.
THE UNWASHED VERSION OF HISTORY: BLOOD ON OUR HANDS
How do you calculate the value of 50 million lives, most of them in sub-Saharan Africa, most of them children? Sadly, you have to go to a politically motivated website to find this figure in proper context, and an an excellent summary of DDT's history:
"As recently as 2005, 500 million people around the world (approximately one-twelfth of the earth's population) were contracting malaria on an annual basis; and each year, 2 to 3 million of them died as a result. Since the 1972 U.S. ban on DDT, more than 50 million people--about 90 percent of whom resided in sub-Saharan Africa, and most of whom were children younger than five--have died of malaria. Said the World Health Organization, "more people are now infected [with malaria] than at any point in history," with "up to half a billion cases [being reported] every year." Anywhere from 1 to 2 million of those people die from the disease. Dr. Wenceslaus Kilama, chairman of Malaria Foundation International, placed this figure into perspective: "This is like loading up seven Boeing 747 airliners each day, then deliberately crashing them into Mt. Kilimanjaro." "The resurgence of a disease that was almost eradicated [many] years ago is a case study in the danger of putting concern for nature above concern for people," said Nizam Ahmad, a Bangladeshi analyst who focuses on the problems that affect developing countries.
Or find this Wayback New Yorker article describing the human triumph of malaria eradication that may well be from the point of view of DDT itself, for no other measure taken deserves near as much praise. Or this which cites a telling South African infection/mortality study with a particularly chilling graph.
Or the paper The Burden of Early Exposure to Malaria in the United States, 1850-1860: Malnutrition and Immune Disorders [2007] which not only describes the direct impact of malaria in the United States, but also suggests some previously-unexplored side effects of such an endemic disease on populations that made life really suck. For example, "Union Army recruits who spent their early years in malaria-endemic counties were 1.1 inches shorter at enlistment due to malnutrition and were 13 percent more susceptible to infections during the U.S. Civil War as a result of immune disorders than were those from malaria-free regions."
I'm not bringing all this up because I'm trying to convince you that Malaria is bad. We know it's bad. But in the early 1970s something happened within the United States and
<blink>down the rabbit hole</blink>
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