Thinking Citizen Blog — First Malaria Vaccine Approved by the WHO— How Big a Deal?
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Thinking Citizen Blog — Thursday is Health, Health Care, Health Insurance and Global Health Policy Day
Today’s Topic: First Malaria Vaccine Approved by the World Health Organization (WHO) — How Big a Deal?
Malaria kills about 400,000 people a year. 94% of these are in Africa. 67% are children. Over 99% of the deaths in Africa are caused by one species — Plasmodium falciparum. “In 2019, 6 countries accounted for approximately half of all malaria deaths worldwide: Nigeria (23%), the Democratic Republic of the Congo (11%), United Republic of Tanzania (5%), Burkina Faso (4%), Mozambique (4%) and Niger (4%).” Today, a few excerpts from a New York Times article on the WHO approval of the first malaria vaccine. Plus three charts. Reminder: it was DDT that led to the eradication from the southern United States between 1947 and 1951. There has been a huge controversy over the human cost of the subsequent banning of DDT. The WHO’s goal for 2030 is to reduce malaria mortality by 90%. Experts — please chime in. Correct, elaborate, elucidate.
BACTERIA, VIRUSES, AND PARASITES — first anti-parasite vaccine
1. “The vaccine, called Mosquirix, is not just a first for malaria — it is the first developed for any parasitic disease.” (first link below)
2. “Parasites are much more complex than viruses or bacteria, and the quest for a malaria vaccine has been underway for a hundred years.”
3.“It’s a huge jump from the science perspective to have a first-generation vaccine against a human parasite.” (Dr. Pedro Alonso, director of the World Health Organization’s global malaria program)
MODERATE EFFICACY — 50% against severe malaria in the first year, but drops to zero in the fourth
1. Upside: “could prevent 5.4 million cases and about 23,000 deaths in children younger than five each year.”
2. Limit: “the trials did not directly measure the vaccine’s impact on deaths, which has led some experts to question whether it is a worthwhile investment in countries with countless other intractable problems.”
3. “A recent trial of the vaccine in combination with preventive drugs given to children during high-transmission seasons found that the dual approach was much more effective at preventing severe disease, hospitalization and death than either method alone.”
A PARTICULARLY INSIDIOUS DISEASE, BED NET EFFICACY, DOSAGE
1. “The malaria parasite, carried by mosquitoes, is a particularly insidious enemy, because it can strike the same person over and over. In many parts of sub-Saharan Africa, even those where most people sleep under insecticide-treated bed nets, children have an average six malaria episodes a year. Even when the disease is not fatal, the repeated assault on their bodies can permanently alter the immune system, leaving them weak and vulnerable to other pathogens.”
2. “Bed nets, the most widespread preventive measure, cut malaria deaths in children under 5 only by about 20 percent.”
3. “Mosquirix is given in three doses between ages 5 and 17 months, and a fourth dose roughly 18 months later. Following clinical trials, the vaccine was tried out in three countries — Kenya, Malawi and Ghana — where it was incorporated into routine immunization programs. More than 2.3 million doses have been administered in those countries, reaching more than 800,000 children. That bumped up the percentage of children protected against malaria in some way to more than 90 percent, from less than 70 percent.”
FOOTNOTE — A LITTLE HISTORICAL PERSPECTIVE (last two links for details)
https://www.nytimes.com/2021/10/06/health/malaria-vaccine-who.html
https://www.nature.com/articles/d41586-021-02755-5
https://en.wikipedia.org/wiki/Human_parasite
https://ourworldindata.org/malaria
National Malaria Eradication Program
Malaria | Bill & Melinda Gates Foundation
China’s successful elimination of malaria, and its global impact
For the last three years of posts organized by theme:
PDF with headlines — Google Drive
YOUR TURN
Please share the most interesting thing you learned in the last week related to health, health care or health care policy — the ethics, economics, politics, history…. Or the coolest, most important thing you learned in your life related to health are or health care policy that the rest of us may have missed. Or just some random health-related fact that blew you away.
This is your chance to make some one’s day. Or to cement in your mind something really important you might otherwise forget. Or to think more deeply than you otherwise would about something that matters.
