The long road of progress: why it’s taken 30 years to develop a malaria vaccine

malaria vaccineThe history books are awash with scientists who have dedicated their lives to a particular cause. From Copernicus to Edison and Pasteur, there’s never been a shortage of supremely gifted and focused individuals selflessly working towards the betterment of humankind.

Joe Cohen is one such pioneer, for he has spent half of his life working on the development of a vaccine for malaria.

The 70 year old originally started the project back in 1987 after he was asked by the then SmithKline & French to spearhead a malaria research unit.

The result of relentless endeavour

As with all great scientific minds, Cohen’s story has been marked by persistence, hard work, and relentless endeavour.

His research unit has outlived several chief executives and a succession of business mergers in spite of its relatively slow progress – the majority of vaccines take 10-15 years to develop.

Members of his research team have come and gone and hit the hundreds over the years, and their combined expert efforts has still left them puzzled and perplexed by the complexities of the malaria parasite which, over its lifetime, produces more than 5,000 proteins.

The challenge to scientists lies in the fact they have to determine which of those proteins to imitate to trigger an immune response in the body. By figuring this out they will be able to protect future generations from the parasite.

A new wave of research

During the 1960s, scientists managed to decode a specific protein of the malaria vaccine – referred to as circumsporozoite (CS) – which kick-started a new wave of research exploring its potential as a vaccine.

Several other scientific teams toiled away at using the protein in a vaccine, but all of them failed. It was only when Dr Cohen’s team hit an epiphany moment – or as he called it, a “fundamental insight” – that their scientific revelation would form the basis of their work for the next decade. They understood that by combining part of an already-existing Hepatitis B vaccine with the CS protein they could create a successful shot.

The trials begin….

In the early 1990s, the first series of tests were carried on US adults. They were successful and proved the concept worked, and this started a chain reaction of trials which showed just how effective the vaccine could be across sub-Saharan Africa, the region where malaria is most prevalent.

It was a long, slow process for even though Dr Cohen and his team could see the viability and potential for their discovery as early as 1997, the reality is that it took another 16 years to accumulate sufficient evidence that it was efficacious across all groups, in a variety of settings, and useful for a significant period of time.

The research programme hasn’t suffered notable setbacks since it began trialling the vaccine back in the late 1990s in Africa – but recent conclusions from the research have shown the vaccine may not have been as successful as the team had originally envisaged.

The quest for a cure continues

Over the last year, results of the vaccine’s effectiveness have diminished, and findings released last October suggested the malaria shot offers substantially less protection for small babies, the reasons for which remain unknown.

Malaria’s unprecedented scale, however – killing 660,000 in 2010 – means the vaccine doesn’t need to be totally effective to make a massive difference.

But there are profound economic implications, as recent studies have suggested a 10% reduction in malaria could add 0.3 percentage points to GDP of countries in which the disease is particularly prevalent.

A ‘milestone’ child malaria vaccine

The ongoing quest for a malaria vaccine has hit the headlines recently with news that the world’s first malaria vaccine for children could be approved for use in 2015.

Researchers found that, for every 1,000 children who received the vaccine, an average of 800 cases of the illness could be prevented, with continuing trials providing protection 18 months after the injections were given. For infants aged between six to 12 weeks, the drug reduced cases of malaria by a quarter.

And whilst the effectiveness of the drug did appear to wane over time, researchers found it had the largest impact in areas with the highest rates of the disease.

At Dr Fox, we stock a range of anti-malaria treatments with a free online consultation.