Thursday 29 April 2021
The man who has dedicated his life’s work to fighting malaria may have finally cracked it.
Claudia Williams: Hi, I’m Claudia – and this is Sensemaker.
One story every day to make sense of the world.
Today, the man who dedicated his life’s work to a single cause … and has finally made a world-changing breakthrough.
2020 was meant to be a big year – just not in the way we’d thought. It was meant to be a year of great progress in fighting one of the world’s biggest killers: a parasitic disease… malaria. If everything had gone to plan, the final step in developing a vaccine for malaria – a large-scale trial of it – would have taken place.
But instead, as we know – another disease, coronavirus, took centre stage. And when the pandemic hit early on in 2020, the world’s attention shifted. Nearly all the work on other vaccines stopped as scientists raced to beat this strange new virus.
And because of that shift in attention, the people who had been fighting the battle against malaria began to worry.
“When people look for a silver lining in Covid-19, they often point out that it usually spares young children. But here’s what people also have to understand. Covid-19 may not be killing many young children, but the effects of the pandemic can.”Bill Gates speaking about malaria
The battle against malaria has been a long one. It’s a disease that’s existed since human civilisation began. In 2019 there were an estimated 229 million cases of malaria worldwide, with deaths estimated to be at 409,000 – mostly in children.
Scientists have been trying to find a vaccine for it since 1908. And one man who’s spent the best part of thirty years on this campaign is Professor Adrian Hill. He’s head of Oxford’s Jenner Institute – a name you might be familiar with. They’re the same team behind the Oxford AstraZeneca vaccine for coronavirus.
This was Adrian Hill back in 2010…
“So malaria is a good example of something that’s very difficult to make a vaccine for, where lots of different vaccine concepts have to be tested.”Professor Adrian Hill speaking in 2010
What scientists like him really needed was the “ultimate experiment” in vaccinology. The chance to try out different vaccine technologies on the same disease but in a competitive race, head to head, to force development and innovation.
That way, they’d learn more about transmission, effectiveness, and how long immunity lasts and that’s exactly what the race to find a vaccine for Covid-19 has done. We’ve learned a lot about vaccines along the way.
So now that scientists have had their “ultimate experiment” in vaccinology, the question is: might the coronavirus have actually helped us develop a vaccine for malaria?
Now you’d think that a disease which kills almost half a million people every year, most of them children in Africa, would be at the top of anyone’s priority list.
But developing vaccines is expensive…
“… and we’re talking about a huge amount of money, probably close to a billion pounds from the idea to market supply of the vaccine.”Professor Adrian Hill speaking in 2010
… they’re also a big risk for a company to take…
“And so this leads to the paradox that because the disease is only in the poor countries, it doesn’t get much investment. For example, there’s more money put into baldness drugs than are put into malaria, now baldness it’s a terrible thing… and rich men are afflicted.”Bill Gates speaking at a TED talk about malaria
So funding is an issue. But so is the disease itself. Where coronavirus has just a few types of proteins, a malaria parasite has 5,000. And its ability to make 5,000 different proteins means it has a greater number of fighting defences at its disposal.
Not only that, but the parasite plays tricks. It changes its own antigens – the types of proteins that trigger an immune response – to stop the human body from recognising it. But there’s one rare protein which Adrian Hill and his team have managed to preserve… and it’s helped them develop a vaccine formula which was successful enough to reach the final stage of trials.
“It’s in this lab 100km away from Burkina Faso’s capital Ouagadougou, deep in the Sahal region, that a groundbreaking discovery was made.”Nicolas Haque, reporting for Al Jazeera
Back in 2019, using 450 participants from West Africa’s Burkina Faso, Adrian Hill and his team ran a successful vaccine trial. The results showed the vaccine was 77 per cent effective, breaking the World Health Organisation’s target of finding a vaccine that’s 75 per cent effective by 2030.
“The world could be free of malaria, one of the oldest and deadliest diseases to affect humanity within a generation.”BBC News
And because of this success, Adrian Hill’s team has been able to start the final trial phase which hopes to show large-scale safety. If that’s a success too, the only remaining challenge will be licensing.
Now before the Covid-19 pandemic, Adrian Hill expected this to take several years but after seeing how fast things can move, and if the trial produces strong results, he hopes that just like they did for Covid vaccines, regulators might reconsider their timeline.
Coronavirus has changed the game in vaccine development. It has shown everyone that when the right funding and incentives are there, you can speed up vaccine trials, speed up approvals, and most importantly, save lives.
Today’s story was written and produced by Imy Harper.