Two years ago, 3.2 billion people around the the world were at risk of malaria infection. There were 198 million cases of malaria. About 548,000 people died from malaria, and 90 percent of malaria deaths were in Africa, according to a World Health Organization (WHO) report.
There is a global need for a malaria vaccine, but there is no commercially available malaria vaccine due to the complexity of the malaria parasite that makes vaccine development difficult.
GlaxoSmithKline has been developing and conducting trials of its malaria vaccine, known as RTS,S or Mosquirix. RTS,S was in development for almost three decades and has moved further in the approval process than any other vaccine.
But WHO experts recently announced that the vaccine should not be used on a wide-scale level for three to five years, dashing hopes in the medical world.
Malaria vaccination are not as effective as other vaccines that combat other diseases, like smallpox. Smallpox is the only disease that has been eradicated worldwide with vaccines as the principal tool, according to Christopher Plowe, associate director for research training at the Center for Vaccine Development.
“I don’t think the World Health Organization is delaying the RTS,S vaccine — they are saying we need to figure out where, when, and in what specific populations the vaccine, which only works partially, will do the most good,” Plowe explained. “If we had a more effective vaccine that worked equally well in all people, it would be more straightforward — and this is what we really want to achieve.”
Plowe’s research involves studying how malaria parasites evolve to escape the effects of the human immune system and drugs. Understanding their evolution can help to track, map, and ultimately eliminate malaria by designing effective tools and vaccines.
The goal is to effectively eradicate malaria worldwide, like scientists have achieved with smallpox, Plowe said. But until there is a more effective vaccine, interventions in African and Asian countries most affected by malaria are critical. Insecticide-treated bed nets and indoor residual spraying for homes in areas with heavy mosquito populations are also key to prevention, and an award-winning new at-home urine test kit could save lives with earlier and more accurate diagnoses.
“The important thing is controlling or preventing malaria. If the vaccine comes, that will be great. But it will take time.”
“The important thing is controlling or preventing malaria,” says Muhiuddin Haider, clinical professor and health literacy expert at the University of Maryland’s school of public health. “If the vaccine comes, that will be great. But it will take time. For now, there should be a seasonal approach to prevent malaria. This should be massive mobilization for community awareness to promote the use of bed nets and to participate in production of bed nets that meet WHO standards.”
But there are challenges in this war against malaria. According to Haider, who has led health projects in multiple countries in Africa and Asia, communities in these regions must emphasize networking to have a clean environment, awareness by making malaria prevention a part of the primary education, and surveillance so the water supply does not become stagnant.
“We can keep making good progress with what we have in hand, and when we get a good vaccine we believe we can win the war against malaria,” said Plowe. “But we have to be relentless — if we back off, the parasite will come roaring back.”
HaeMee Lee is a contributing writer at Plex. She studies journalism at the University of Maryland.
