New leaders, tools can transform malaria fight

Jul 29, 2010

THE African Union (AU) meeting will be remembered for its courage. Just a few weeks after a devastating terrorist attack in Kampala, the AU convened in Uganda’s capital city to tackle our most urgent priorities.

By Madiké Seye

THE African Union (AU) meeting will be remembered for its courage. Just a few weeks after a devastating terrorist attack in Kampala, the AU convened in Uganda’s capital city to tackle our most urgent priorities.

With the attacks still fresh on our minds, it was inspiring to see that African heads of state went ahead to make time for meetings of the recently formed African Leaders Malaria Alliance (ALMA).

ALMA, a group dedicated to finding new solutions to malaria, has pledged to make real progress against the disease with every tool available to the international community, including bed nets, indoor residual spraying and top-quality drugs. We also need to start thinking about new tools, including a malaria vaccine, which could complement existing interventions.

Vaccines and immunisation services have been critical to improving Africa’s health over the last several decades. Anyone whose child has suffered from malaria — and there are only few of us who have not directly been affected by the disease — can imagine what a malaria vaccine would mean.

Several years ago, when I started working in pharmaceuticals, a malaria vaccine was only a distant dream. But today, the leading malaria vaccine candidate is in Phase III trials in seven countries across Africa. RTS,S, as the vaccine candidate is known, is the result of years of collaboration.

It originated in GlaxoSmithKline’s laboratories more than two decades ago, and for the last 10 years has been evaluated by leading African researchers in partnership with the PATH Malaria Vaccine Initiative. So far, 10,000 infants and young children have been enrolled in this pivotal trial in Burkina Faso, Gabon, Ghana, Kenya, Malawi, Mozambique and Tanzania.

The vaccine candidate is approaching the end of a long journey. Trial results have consistently shown that RTS,S has an acceptable safety profile and could reduce the risk of malaria by half in children living in malaria-endemic regions in sub-Saharan Africa.

Clinical studies have also shown that RTS,S can be used alongside other vaccines given routinely to infants, such as those for tetanus, diphtheria, pertussis, hepatitis B, polio and measles. Initial data from the Phase III trial will be available late next year. If all goes well, general implementation of RTS,S for infants would be possible within five years or so.

With a malaria vaccine candidate on the horizon, now is the time to prepare for its introduction as five years can go by quickly. Partners need to engage and we need to start thinking about how to ensure RTS,S reaches those who need it most: Africa’s children.

The process could start by engaging groups like ALMA and international organisations such as the Roll Back Malaria Partnership and the Global Fund, which have helped finance and introduce the best malaria interventions over the last decade.

As ALMA understands, policy makers will need to design a policy framework and strengthen health systems, so that once the day comes and if appropriate, a malaria vaccine may be used together with the existing malaria control and immunisation programmes. This means everything from improving infrastructure and delivery systems to training healthcare workers to administer a new vaccine.

These efforts can build upon work that is already underway for other new tools, such as rotavirus and pneumococcal vaccines.

For our part, GSK is doing all that it can to ensure that the price of RTS,S will not be a barrier to its use. Earlier this year, our CEO Andrew Witty announced that GSK will sell RTS,S at the cost of goods, plus a small 5% charge that will be directly reinvested into research for next-generation malaria vaccines or vaccines for other neglected diseases. Such an approach should ensure that pharmaceutical companies continue to invest in research for similar vaccines. GSK believes in broad collaboration to advance research against diseases like malaria and is also opening up its library of compounds of potential malaria drugs for researchers anywhere in the world to pursue.

All over the world, countries, multi-laterals, NGOs and scientists are motivated to advance the fight against malaria. ALMA is a great example of what Africans can do when we work together on the highest level.

In the years ahead, as the vaccine candidate gets closer to implementation, I hope ALMA and its friends gather at another African Union meeting to discuss new malaria interventions such as RTS,S, should Phase III results confirm studies to date.

We have to start working together now to make sure Africa is ready for a vaccine. One day there may be means to save many more lives and change the equation in the fight against malaria for good.

The writer was the vice-president sub-Saharan Africa for GlaxoSmithKline since 2006 and has worked with the company since 1990

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