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AFRICA: New hope for malaria vaccine
Health experts say any future vaccine should be part of broad prevention efforts

DAKAR, 22 December 2008 (IRIN) -

The world’s most clinically advanced malaria vaccine trials have given new hope in the fight against the disease, which in sub-Saharan Africa kills a child every 30 seconds. Malaria experts recently meeting in the Burkina Faso capital Ouagadougou say promising vaccine research aside, governments in West Africa must step up existing measures to prevent the spread of the disease. Results published on 11 December in the New England Journal of Medicine showed that the vaccine candidate RTS,S/AS (made by GlaxoSmithKline (GSK) Biologicals), provides both infants and young children with significant protection against malaria. “We are closer than ever before to developing a malaria vaccine," said Christian Loucq, director of PATH Malaria Vaccine Initiative (MVI), the organisation coordinating the global effort.

The Roll Back Malaria (RBM) partnership says malaria is the leading cause of death of under-five children in Africa, and in pregnant women increases the chances of low birth weight, anaemia or early infant death. Malaria is endemic in most West African countries. The World Health Organisation (WHO) says malaria causes an average loss of 1.3 percent of economic growth in countries with intense transmission. Scientific success Two separate ‘second phase’ trials of versions of the RTS,S/AS drug were conducted in Kenya and Tanzania, and reaffirmed earlier study results, supporting the launch of a further, ‘stage three’ trial. In children aged five months to seventeen months, the candidate RTS,S/AS01 reduced the risk of clinical episodes of malaria by 53 percent, over an eight-month period.

It was also shown to have a promising safety profile. And for the first time, data from the study of RTS,S/AS02 showed that the drug can be used in infants, as part of existing national immunisation programmes. “The vaccine works alongside standard infant vaccines of the World Health Organisation’s (WHO) Expanded Program of Immunization (EPI), and has consistently shown a significant efficacy level,” said Joe Cohen, a co-inventor of the vaccine and vice-president of Research & Development, Emerging Diseases & HIV at GSK Biologicals. Holistic approachOne RBM official, who took part in the Ouagadougou malaria conference, said the vaccine progress is welcome news but does not change the need for better prevention efforts in West Africa. “This new research is positive but it doesn’t change our message – countries still need to modify their strategies, especially in prevention and treatment”, Boi-Betty Udom, RBM partnership facilitator, told IRIN. “We’re hopeful a vaccine could be part of a holistic approach to malaria control, as a way to reduce the severity of malaria attacks.”

At the Ouagadougou meeting WHO and RBM officials urged West African governments to work to reach more people with preventive measures. Udom said just 20 percent of people – mainly under-five children and pregnant women – are being targeted. Stephan Tohon of WHO’s malaria programme in Burkina Faso said too narrow a focus might mean that preventive tools like insecticide-treated nets (ITN) are not being used as they should. “Ten years ago we focused on the most vulnerable populations – women and under-five children – but today we realise that where there is a mosquito net it’s often the head of the household who uses it.” WHO’s latest world malaria report says surveys in 2006-07 in 18 African countries showed that 34 percent of households owned ITNs and 23 percent of under-five children slept under the nets. Experts at the meeting noted that none of the countries in West Africa have met the African Union’s 2003 Maputo declaration, which stipulated that governments allot 15 percent of the national budget to the health sector.

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