A Major Breakthough in Public Health

One of the major scourges of the developing world is disease, and in Africa, malaria is one of the biggest killers. Approximately 1 million people -- primarily children under the age of 5 -- die every year, and more than 2 million are sickened.

But hope is on the way. The Los Angeles Times reported yesterday that clinical trials of a malaria vaccine by GlaxoSmithKlein Biologicals have more than halved the infection rate among children in Kenya and Tanzania.

A vaccine against the parasitic disease malaria cut illnesses by more than half in field trials and could be safely given with other childhood inoculations, two studies have reported. The vaccine, which will begin a third and final phase of clinical trials early next year, could become the first to protect children from malaria, which kills nearly 1 million people worldwide every year.

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In the first study, conducted in Kenya and Tanzania, 894 children ages 5 months to 17 months were inoculated either with the three-dose experimental malaria vaccine or a rabies vaccine as a control group. In the eight-month follow-up period, researchers found that children receiving RTS,S had 53% fewer diagnosed cases of malaria -- 38 episodes compared with 86 among recipients of the control rabies vaccine.

In the other study, conducted in Tanzania, the vaccine was given to 340 infants at 8, 12 and 16 weeks old, along with vaccines against polio, diphtheria, tetanus, pertussis (whooping cough) and Haemophilus influenzae B without lessening the safety or effectiveness of the vaccines. The ability to administer the vaccine as part of already established immunization programs is important for countries where health workers, clinics and roads are in such shortage that delivering a drug can be almost as challenging as developing one, researchers say.

Again, the trial was randomized and double-blinded -- considered the scientific gold standard -- with half the infants receiving the malaria vaccine and the other half receiving a hepatitis B vaccine as a control. Although it was not the main object of the study, the researchers found that infants who received the malaria vaccine had 65% fewer infections, as measured by the presence of parasite in the bloodstream, over a six-month period than those who did not, confirming the findings from an earlier, smaller study.

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In the last few years, widespread distribution of insecticide-treated bed nets and a new combination of medicines have reduced malaria deaths in Ethiopia, Rwanda and Zambia by 50% and more. But because of the threat that Plasmodium falciparum could develop resistance to medications or insecticides, health workers consider a vaccine to be a vital tool. Developing such a vaccine has proven a challenge because the parasite is adept at evading the immune system.

This is spectacular news. Disease is a primary cause of underdevelopment, as it kills children, destroys communities, and undermines the economic bases of life. Ending diseases such as malaria is a vital step towards improving the lots of billions of people around the world. Pharmaceutical companies such as GlaxoSmithKlein have long come under fire for ignoring the health concerns of the developing world, instead preferring to produce medicines aimed at the richer developed world. So let's now give credit where credit is due: Congratulations to GlaxoSmithKlein for working towards ending one of the developing world's worst killers.