An experimental malaria vaccine, made by GSK with backing and support on the research side from the Bill & Melinda Gates Foundation and Seattle-based PATH, has (again) been shown to protect half the children in the study were immunized against malaria.
The results, announced today in Durban, South Africa, are pretty much the same as earlier findings that continue to emerge from a long, ongoing study of GlaxoSmithKline’s RTS,S vaccine.
The scientific gist of the latest findings, as was reported back in 2008, is that the vaccine appears to protect about half the kids from getting sick, its ability to protect drops significantly following vaccination, it requires repeat doses and GSK estimates it will cost a few dollars at least.
Is that a glass half full or half empty?
News reports today generally celebrate this as a glass half full.
Guardian Malaria vaccine: Hopes rise
The latest study, though its results are essentially the same as reported repeatedly in earlier phases of the clinical research, are being celebrated for a variety of reasons:
First, this shows that a vaccine against malaria is technically possible – no small feat given the parasite’s amazing ability to adapt and do end-runs around efforts to prevent or treat disease. Secondly, even a halfway effective vaccine could prevent hundreds of thousands of deaths and millions of cases of disease in children. Even if a child survives malaria, many suffer long-term damage from the infection.
Yet few American parents would likely accept a vaccine that only works half the time, and one that may need booster shots every few years to continue to protect children against the infection.
“But we need to look at this in the context of how widespread severe malaria is in the developing world,” said Kathy Neuzil, director of PATH’s vaccine access and delivery program. “This vaccine could still prevent a tremendous amount of malaria …. From a public health point of view, you’re seeing a significant impact in terms of case reduction.”
True enough. If the results in the clinical trials do prompt regulatory approval of RTS,S and the vaccine proves equally effective in messy reality (efficacy usually drops when a vaccine moves from clinical research to routine use), that’s progress. But there may still be concerns with it losing strength over time, requiring multiple shots to stay effective and the cost.
Most of those who die from malaria are the very poor and a vaccine that costs a few dollars per dose — when administered to millions at risk — may be too expensive.
Another kind of context may be useful. Most malaria experts would agree that the Gates Foundation’s investment in malaria vaccine research – and its endorsement of pushing for eradication rather than control – has reinvigorated the field. Yet many, if not most, of these experts are also getting funding from the Gates Foundation (as do NPR and the Guardian, I should note) or seeking funding. And the Seattle philanthropy has made it clear it likes ‘success stories’ as opposed to narratives emphasizing barriers to progress.
Humanosphere covered a Gates malaria forum in 2011 in which GSK and others working on the RTS,S vaccine presented their results (showing 50 percent efficacy, etc.). Malaria experts privately told me of their reservations that the vaccine would ever be feasible for use in the developing world, but few wanted to say so publicly.
As one top malaria expert said, anonymously, of the meeting: “It’s been a bit like singing Kumbaya around the campfire.”
In short, the news today is not really that new and this experimental malaria vaccine is, at best, a glass half full. But that still represents significant progress – scientifically, and perhaps in terms of its public health utility – in a field where the glass stood mostly empty for perhaps half a century.