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After more than three decades of work and almost $1 billion of investment, GlaxoSmithKline and its partners are ready to deploy a vaccine for malaria, the mosquito-borne disease that kills almost half a million people each year.
The vaccine, developed with the non-profit organisation PATH, comes at a critical time and marks a milestone in the battle against the parasite that causes malaria. But the injection is a pioneer, not a panacea: It prevented only about four in 10 malaria cases among children who received four doses in a large study.
A pilot programme is scheduled to begin this month in Africa to size up the product, which has the potential to save tens of thousands of childrens lives, according to the World Health Organization. After declining for many years, malaria is staging a comeback. The ultimate impact may depend on securing more international funds at a time when countries are increasingly turning inward.
Funding baton
“Mobilising funding for these major endeavours which do not have a commercial opportunity has been a challenge, and will be an even bigger challenge in the future,” said Thomas Breuer, Chief Medical Officer of Glaxos vaccine’s unit.
UK drugmaker Glaxo, which estimates its spending more than $700 million on the project, would like to hand over the funding baton to others, according to Breuer.
The vaccine brings a key new tool beyond mosquito nets, insecticides and drugs in the battle against a disease that the WHO estimates killed 435,000 people in 2017. Children under the age of five in Africa are particularly vulnerable, accounting for about two-thirds of all deaths.
With kids in some regions getting multiple episodes of malaria in a year, even a partially effective vaccine could have a big impact, said Mary Hamel, coordinator of the programme for the WHO. The pilot is scheduled to start in Malawi next week and expand to Ghana and Kenya next.
“A vaccine that is highly efficacious — 90 per cent or so — that’s not in view at this point,” she said. “But this vaccine getting to where it is shows that a malaria vaccine can be made. It will be a pathfinder.”
Crossing hurdles
The effort underscores the challenge of developing products for poorer countries that carry costs extending well beyond clinical trials and approvals, said Ashley Birkett, Director of PATH’s Malaria Vaccine Initiative.
“There’s still another tranche of many, many tens of millions of dollars, possibly hundreds of millions of dollars and many years, before they’re out there being sold,” he said.
The main hurdle for the malaria vaccine is getting protection to persist for longer, Birkett said. Glaxo is working on a new approach in mid-stage studies that relies on the same basic vaccine formula but involves delaying one of the doses and reducing the amount of the antigen, according to Breuer.
The malaria parasite turns out to have greater genetic diversity than previously believed, compounding the challenge.
With more than 5,000 genes, its a complicated microbe, and the pursuit of a vaccine has led to numerous dead ends, Hamel said. Early development of the Glaxo shot began around 1984. As the pilot starts in Africa, scientists are looking to the potential next generation of technology.
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