West Africa Leads on Malaria Vaccine

ADF STAFF

African scientists are at the forefront of a new malaria vaccine that has proved highly effective in early trials and is being hailed as a potential breakthrough.

A recent study in British medical journal The Lancet showed that the R21/Matrix-M vaccine prevented the disease more than 77% of the time in early trials — the first time a vaccine candidate has surpassed the 75% efficacy goal set by the World Health Organization (WHO).

“These are very exciting results showing unprecedented efficacy levels from a vaccine that has been well tolerated in our trial program,” Halidou Tinto, principal trial investigator, said in a statement. “We look forward to the upcoming phase three trial to demonstrate large-scale safety and efficacy data for a vaccine that is greatly needed in this region.”

Scientists worldwide have worked since the 1940s to develop a vaccine to protect against malaria, which infects about 200 million people a year and kills more than 400,000 a year.

Nine of 10 malaria victims live in Africa, and most are children under 5.

Abdoulaye Djimdé is director of the Malaria Research and Training Center in Bamako, Mali, where defeating one of the continent’s worst killers has been the focus for 30 years.

“Living in the communities, suffering from the disease, and having our children and our siblings suffering from the disease — it gives you a fresh look at the problem,” Djimdé told Smithsonian Magazine. “We are here to solve problems that our people and we ourselves suffer from.”

R21 was developed through a collaboration of the Kenya Medical Research Institute, the University of Oxford, the London School of Hygiene & Tropical Medicine, United States pharmaceutical company Novavax, the Serum Institute of India, and the Institut de Recherche en Sciences de la Santé in Burkina Faso, where Tinto is regional director.

The yearlong phase two trial was conducted on 450 children, 5 to 17 months old, from 24 villages in Burkina Faso’s Nanoro area. The children got three doses and have since had a booster shot.

Phase three trials will test R21’s safety and effectiveness in 4,800 children, 5 to 36 months old, in Burkina Faso, Kenya, Mali and Tanzania.

“We are always nervous when a vaccine reaches this phase,” Djimdé said.

Africa has recorded more deaths from malaria than from COVID-19 in the past year, according to WHO and Africa CDC data. Scientists say the malaria parasite is particularly hard to combat because has more than 5,000 genes compared to the virus that causes COVID-19, which has 12.

Efforts to combat malaria have been hampered in recent years due to a shift in funding to COVID-19 that has disrupted research. The WHO warned of “considerable loss of life” due to delayed programs.

Tinto and his colleagues think R21 is the missing piece.

“The five African institutions involved in this partnership have a historic role to play,” Tinto said. “We are all committed to work hard in order to generate data that will provide regulators and policy makers with the evidence needed to support the registration of this vaccine.

“If successful, this vaccine should be made available as quickly as possible to complement existing malaria prevention tools.”

That could take as little as two years.

The Serum Institute of India, the world’s top manufacturer of COVID-19 vaccines, has agreed to produce the malaria vaccine. The WHO is receptive.

“It may well be possible to accelerate regulatory review,” said David Schellenberg, a science advisor for the WHO’s Global Malaria Program. “I think we’re all very keen to learn as many lessons from COVID as possible.”