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The quest for a malaria vaccine

By Dr Tsiri Agbenyega
Posted on Friday, 23 April 2010 10:06

In the Know features an interview, opinion or analysis on the events making the news in Africa each week.

The most promising malaria vaccine enters the last trial phase as global actors in the field take 25 April to commemorate the efforts of researchers, aid agencies and international organisations to eradicate a disease that kills an estimated one million people per year. Vaccine researcher Dr Tsiri Agbenyega examines the progress made and the obstacles that remain for the development of an effective vaccine.

Malaria takes a devastating toll on communities in Africa. In Ghana, like many African countries, malaria is the one of the most deadly diseases for children under the age of five. We will need to use every tool available, including bed nets, indoor residual spraying and drugs, to fight this disease. A vaccine would complement existing interventions and has the potential to save hundreds of thousands of lives each year.

On World Malaria Day this year, the international community marks a historic milestone in the fight against malaria. This past year, GlaxoSmithKline Biologicals’ launched Phase III efficacy trial of the world’s most advanced vaccine candidate in 11 research centres across seven African countries. Phase III is the last big step for a vaccine candidate before its submission for approval to regulatory authorities.

A mere 15 years ago, few thought that the development of a malaria vaccine would get this far.

Back then, no vaccine candidate had shown efficacy in protecting against malaria, research centres in Africa were not conducting large vaccine trials and there were few international partnerships pursuing malaria vaccine research. This has all changed because many people never lost hope.

RTS,S, as the vaccine candidate is known, has been in development for more than 20 years, including a decade of clinical research in Africa. Trial results have consistently shown that it has a promising safety profile and could reduce the risk of malaria in children by half. In clinical studies, RTS,S demonstrated that it can also be used alongside other routine vaccines, such as those for measles, tetanus, diphtheria and polio.

The vaccine candidate is the first designed specifically for use in Africa, and clinical trials are well underway in Burkina Faso, Gabon, Ghana, Kenya, Malawi, Mozambique and Tanzania. To date, of the projected 16,000 participants, more than 8,500 children and infants have been enrolled.

The Clinical Trials Partnership Committee is a group of leading African research institutions that manages the RTS,S trials together with GlaxoSmithKline Biologicals and the PATH Malaria Vaccine Initiative. To be selected for the trial, the research centres needed to have track records of world-class clinical research that met international safety and ethical standards. The centres have increased their capabilities by building new facilities, installing sophisticated laboratory equipment and training staff members to use the latest technologies. Research institutions are becoming even stronger and are attracting new talent to the field.

The research sites work hand in hand with families, local leaders and educators to ensure that the trial is conducted safely, ethically and with the full support and understanding of all those involved. Since the trial began, I have been humbled by the dedication of the families who share our vision and are joining us in this effort to defeat a deadly foe.

Going forward, we must continue to collaborate across sectors and borders to ensure that malarial drugs and other tools of prevention reach the populations that need them the most. Advances in research also have to be met with similar advances in public health capacity and the political will required to widely implement holistic anti-malaria strategies.

Dr. Tsiri Agbenyega is a Principal Investigator at the Agogo Presbyterian Hospital trial site, and former dean of the Medical School at the Kwame Nkrumah University of Science and Technology, Kumasi, Ghana. He heads the malaria research unit at Komfo-Anokye Hospital in Ghana and is co-chair of the RTS,S Clinical Trials Partnership Committee.

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