Special report: the cost of a malaria-free world (Reuters)

 

A child is given a vaccine against malaria in a medical trial in a clinic in the Kenya coastal town of Kilifi, 23 November 2010.

Credit: Reuters/Joseph OkangaBy Kate Kelland and Ben Hirschler

LONDON | Tue December 14, 2010 9: 28 am EST

London (Reuters) - Joe Cohen, a scientist tantalizingly close to deliver the first vaccine for malaria worldwide, is on the stump.

After 23 years of meticulous work of laboratory and a programme of major trials in seven countries, biologist of 67 years, explains the clinical case for vaccine is almost proved. This is a breakthrough moment that could save hundreds of thousands of lives, but when it comes to public health in the developing world, Cohen knows hard sciences is only half the job. This is why researcher u.s. - Italian softly spoken found himself a chilly night of December tongue life operates with rich-world politicians whose voters will have to foot the Bill and commissioning issues more festive mince pies and wine in a dressed in oak room in the Palace of London and leather.

How profitable the vaccine will be compared to proven rudimentary approaches such as mosquito nets and insecticides, an investigator asked. Is there evidence that it will be reducing the spread of the disease in General, help those who have not been vaccinated? How long is effective may remain shot? Is there a danger that it might encourage a false sense of security? The session is happening, it is clear that enthusiasm for the work of Cohen is coupled with mistrust between the expert and knowledgeable legislators. The net issue: is the vaccine - and to the worldwide community of health to completely eradicate a disease that kills a child every 45 seconds - really worth the money?

It may seem absurd thing to ask. Malaria threatens half the population of the planet and kills approximately 800 000 people per year, many of them too young to have even learned to walk. The mortality rate is reached during the last decade, but large-scale eradication cost billion and funds drag away from the other also, or perhaps even more urgent health efforts. Poor country Governments and donors of the rich weigh when placing their money, experts have begun a calm but debate fundamental if wiping on malaria is realistic or even economic sense.

"All funds and human capabilities in the world, there is little doubt that we could eliminate malaria." The question is: what is the best value for our dollar? "And it is more and more urgent that we look at the world economic climate, the question", explains malaria expert Oliver Sabot, who works at the initiative of access health Clinton in Boston.

TARGETING THE PARASITE

What is the best value for our dollar? The answer to this question is obvious to a person as Loyce Dama Karisa, woman Kenya, who recently gave birth to her seventh child, a girl called Rehema. Karisa came in a minibus full of other mothers and babies, a clinic in the mud and thatch Madamani, village in the district of Kilifi, on the South coast of the Kenya.

GlaxoSmithKline, British drugmaker Cohen works, is in the clinic in the biggest medical experience Africa, giving the vaccine for infants and young children in a test to assess its effectiveness. "I wanted my children to get this vaccine," says Karisa. "Malaria is a very bad condition.

Kilifi district hospital, high-dependent children unit is replete with malaria patients. Apathetic babies and toddlers lie motionless in the adult size beds tangles of tubes in their nose, arms and legs. A boy has his hands bandées strains to stop him by pulling a tube in his nose. He screams and whips as a drip is attached to a vein in his foot. Mothers of Spearmint hospital gowns watch silently. A hand his tiny sleep in his own time baby cradles a fan ceiling chops slowly by hot air, does nothing to reduce the heat of drainage.

Kilifi, which, despite its luxuriant vegetation of Green has poor soils for the growth of crops and high levels of poverty, families are almost numb to the ravages of malaria. It is a similar story across the continent: nearly 90 per cent of malaria victims live in sub-Saharan Africa. most of those who are less than five years.

The disease is caused by a parasite in the saliva of mosquitoes. GSK vaccine will work to develop the parasite enters the human bloodstream following a mosquito bite. By stimulating an immune response, it can prevent parasite maturation and multiply in the liver. Without this answer some parasite infection and blood circulation red blood cells, leading to fever, pain in the body and in some cases death.

Vaccine that Cohen and his colleagues have developed combines technology GSK B hepatitis with pieces of the malaria parasite and adds a chemical called an adjuvant to stimulate the immune response of the organism. The result - the first ever human parasite, as opposed to simple bacteria or virus - vaccine is a product that could be given alongside standard childhood vaccines and showed in a phase II or a clinical trial stopped to reduce the risk of clinical episodes of malaria in children by 53% over a period of eight months. Program phase III pivotal, a baby Rehema part of will be injecting the 16,000 African children in February last. If all goes according to plan, the vaccine could be licensed and put into service as early as 2015.

Director of GSK Andrew Witty, says testing goes well and looked forward to closer to the vaccine market – something that said aloud shareholders of the company money, but enable them to rely. "This is the first vaccine which has an effect at all against infection by the parasite." If we went to 20 or 25 years, people have said that it was impossible, "he told Reuters."

Efficiency of approximately 50% means that the vaccine is no panacea. Science and health experts as normally a rate of success of at least 80 percent before a vaccine is accepted for widespread use. There is concern that the availability of the shots could create a false sense of protection, leading people to neglect other measures, such as nets.

But, added to the already extensive range of nets, insecticides and antimalarial drugs, the vaccine - called RTS, S or Mosquirix - could prove a powerful new tool.