The Malaria Vaccine Initiative works to accelerate vaccine development

Fatima awoke to the loud and insistent cries of her daughter Alma, coming from the next room. She rushed to her daughter’s bedside and found Alma crouched in the fetal position, drenched in sweat. She cradled Alma close to her breast to feel her temperature. Immediately she knew her daughter’s fever could be fatal. Fatima rushed to the village doctor carrying Alma in her arms. Crying and praying, she begged for help, but it was too late. Malaria, a disease spread by a tiny insect, took Alma’s life before her fourth birthday.

Alma is one of the estimated million or more African children younger than five years old who die from malaria every year. Malaria places more than one-third of the world’s population at risk; as many as 500 million cases occur every year. The harsh reality is that currently effective antimalarial interventions are not used widely enough, and some have become less effective as the mosquito and malaria parasite develop resistance to widely used insecticides and drugs. A malaria vaccine is desperately needed to help fight the disease before more children suffer and die.

Recent progress in malaria vaccine development proves that a vaccine is feasible. The PATH Malaria Vaccine Initiative (MVI) works to overcome barriers to malaria vaccine development, achieve breakthroughs in the science of malaria vaccines, and pave the way to licensing a vaccine. MVI’s mission is to accelerate the development of promising malaria vaccines and ensure their availability and accessibility in the developing world.

Overcoming barriers to malaria vaccine development

The vast majority of vaccine candidates fail during development, making vaccine development an expensive and financially risky endeavor. The need for a malaria vaccine is urgent, but traditional market forces are not enough to prompt substantial investment in vaccines that protect against a disease that primarily affects people in developing countries. Through effective application of human, financial, and technical resources, MVI helps move vaccines from the laboratory into clinical development efficiently and quickly.

Achieving a scientific breakthrough

MVI contributes to malaria vaccine development by supporting product development efforts and expediting the global flow of information. MVI has established 11 vaccine development partnerships. As of May 2005, MVI was supporting 13 vaccine constructs, 5 of which have entered human clinical trials, and had supported 21 vaccine trials, in Africa, Europe, and the United States. Each of these projects provides valuable data about which concepts work and the interaction between the vaccine, the parasite, and the host. As a result, more and better malaria vaccine candidates are moving into clinical trials today than ever before.

In October 2004, MVI and its partners at GlaxoSmithKline (GSK) Biologicals, Centro de Investigação em Saude da Manhiça, and the Mozambique Ministry of Health reported the results of a highly successful evaluation of a vaccine developed by GSK. In this study, the largest malaria vaccine efficacy trial ever conducted in children in Africa, the vaccine provided significant protection against uncomplicated malaria, against infection, and even against severe forms of the disease for at least six months—a breakthrough in malaria vaccine development.

Paving the way to licensure

MVI is dedicated to ensuring that a malaria vaccine will be licensed and made available to the developing world. One obstacle to progress is the extreme difficulty of developing a vaccine against the malaria parasite—there are currently no licensed vaccines against parasites that infect humans. In addition, because vaccine development is an expensive and financially risky endeavor, companies are slow to invest in developing a vaccine unless they can be sure there is a profitable market. MVI is investigating ways to overcome these obstacles and begin preparing countries to integrate a malaria vaccine, once it is available, into their health systems. MVI has conducted an early-stage assessment of malaria vaccine demand, is collecting key data to feed into appropriate decision-making mechanisms, and is working with partners who have the scientific expertise and commitment to manufacture and license a malaria vaccine.

Steps for the future

Until very recently, the world was still asking whether a malaria vaccine was possible. PATH has played a pivotal role in demonstrating that development of an effective vaccine is not only possible but likely. With greater human and financial resources, much more could be done to halt the damage done by malaria. In the meantime, we strive to make sure that existing tools are used to their full capacity—and we work toward a future in which people are free from the death and disease associated with malaria.