Few scientists ever have the
chance to see their daily work transformed into new medicines or
vaccines that have the potential to save millions of lives. It is mind
boggling to think that I may be one of the lucky few.
Indeed, earlier this year, I went with other scientists to visit the
construction site for the plant that is destined to produce millions of
doses of the malaria vaccine, known as RTS,S. For the past 20 years, I
have been closely involved in the development of this vaccine of which
I am one of the inventors.
This vaccine made history last year when the scientific
journal The Lancet published the results of a clinical trial that
proved it was effective for at least 18 months in reducing clinical
malaria by 35 percent and severe malaria by 49 percent, in a study that
involved about 2000 Mozambican children. If all goes well, this vaccine
could be licensed as early as 2011-2012, and the new production plant
in Belgium should be ready to begin supplying millions of doses each
year to children in many of Africa's poorest countries.
As the world commemorates Africa Malaria Day, it is necessary
to consider how important a step this vaccine may be, but also to
recognize how many challenges remain. Malaria kills between one and
three million people each year, mostly young African children, and is
among the world's leading causes of childhood mortality. Malaria also
robs Africa of crucial resources necessary for development - as much as
US$12 billion each year in healthcare expenditures and lost
productivity, a sum that is roughly equivalent to all the foreign aid
that flows into Africa each year.
For too long, the world has considered a malaria vaccine as
some kind of "pie in the sky." In the light of the recent scientific
breakthrough resulting from the successful RTS,S clinical trial, we
must rethink our views on the feasibility of vaccination against
malaria. Now is the time for the world to start thinking about how to
use the RTS,S vaccine with other existing or soon to be implemented
malaria prevention tools such as insecticide treated bed nets, indoor
pesticide spraying, and intermittent prospective treatment of infants
International organizations need to begin preparing demand
forecasts, national agencies need to lay the groundwork so this vaccine
can be approved as quickly as possible and introduced into national
disease control strategies. Fundamentally, all people across Africa and
the industrialized world need to begin building political support to
ensure the resources, both financial and infrastructural, are in place
to ensure that this vaccine reaches every child who needs it.
It will take a few more years to license the malaria vaccine,
but we don't have to wait that long to start saving lives. Many
countries are already far behind on immunizing children against
diseases such as measles, rotavirus and Haemophilus influenzae type b
disease, for which vaccines already exist.
Immunization is one of the most cost-effective public health
interventions in history, yet funding for vaccines is only a fraction
of what it needs to be. A recent report by the research group
SmartPharma published in the journal Vaccine found that just doubling
the money the world spends on vaccines could reduce vaccine-preventable
deaths by half in five years. This will translate into millions of
And that is only by providing vaccines that already exist.
Major scientific hurdles need to be overcome if we are to develop
effective vaccines for other diseases such as HIV/AIDS and TB that are
devastating the developing world. We are committed, working in
partnership, to address these challenges.
However, billions of dollars more will be needed to fund the
development and purchase of these vaccines. New types of long-term
financing that are currently making headlines, sponsored by forward
thinking governments, could mean a positive overhaul of the short-term
funding and aid mechanisms traditionally used. These new institutions
include the UK-sponsored International Financing Facility for
Immunisation and the G8-sponsored Advance Market Commitment for
But financing for R&D and purchase is only part of the
problem. Improving health in the developing world is a complex
challenge. In many countries, major investment is required in
healthcare infrastructure - hospitals, clinics, distribution networks -
not only for immunization, but to provide daily healthcare. In
particular, how these new vaccines will be introduced in low income
countries and how long it will take regulatory authorities to approve
them are two other hurdles that need to be overcome in order for these
vaccines to get to the people who need them most as quickly as
As excited as I was to tour our malaria vaccine manufacturing
facility last year, I am sure that feeling will pale in comparison to
how I will feel when the first dose of the vaccine is given to a child.
It is heartening to think that the biggest challenge facing a malaria
vaccine today is not scientific, but logistical.
Over the next few years, the world needs to move quickly so
the production of the RTS,S vaccine can be scaled up so it is available
to the 75 million babies born in Africa each year. On Africa Malaria
Day this year, we should be proud of how far we have come, but also
humbled and inspired by how much work remains to rid the world of
Joe Cohen is the inventor of the RTS,S malaria vaccine and
Vice President of R & D, Vaccines for Emerging Diseases & HIV
for GlaxoSmithKline Biologicals.