Malaria Vaccine Passes Key Regulatory Hurdle 34
An anonymous reader writes: The BBC reports that the European Medicines Agency has approved the world's first malaria vaccine for real-world use. The vaccine is far from perfect, and the World Health Organization still has to make a final decision on it, but it's a key victory for GlaxoSmithKline, who have been developing the vaccine for three decades. "The best protection was among children aged five to 17 months who received three doses of the vaccine a month apart, plus a booster dose at 20 months. In this group, cases of severe malaria were cut by a third over four years." Unfortunately, the boosters are quite necessary for protection, and it doesn't protect young babies from malaria. The disease "kills around 584,000 people a year worldwide, most of them children under five in sub-Saharan Africa."
Surprised it could be done (Score:3, Interesting)
Malaria in humans is caused by five different species of plasmodium parasites. That they could get a vaccination at all effective is wonderful and surprising.
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Malaria in humans is caused by five different species of plasmodium parasites. That they could get a vaccination at all effective is wonderful and surprising.
5 is a very managable number. The yearly flu vaccine is, I believe, a mix of the top 3 strains from the previous year. Also, it looks like it might only be targetting one of the strains as it cut cases by only 1/3 so the other 2/3s might have been caused by a non-targetted strain.
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The vast majority of deaths are caused by one species, though, Plasmodium falciparum [wikipedia.org]. Infections from other species can cause serious illness but are rarely fatal.
However vaccines for any kind of parasite are difficult and only recently has real progress been made. As of this 1998 review [sciencedirect.com] there were no effective vaccines against any human parasite.
Bed Nets (Score:2)
Prof Adrian Hill of the Jenner Institute, Oxford, said he was pleased and encouraged by the EMA's decision but added that the vaccine was not a "magic bullet".
He said: "A bed net is more effective than this vaccine, but nonetheless it is a very significant scientific achievement.
While research into a vaccine is great, why haven't we focused efforts on supplying bed nets for everyone? I'm assuming that they'll cost less than the vaccine per unit and they also have the advantage of being reused.
Re:Bed Nets (Score:4, Insightful)
(In the medium to long term, though, a malaria vaccine might be worth a great deal of money, indirectly. One of the nasty things about malaria is that it doesn't kill too many people; but it weakens and debilitates the infected on a massive scale, so regions where malaria is endemic lose huge amounts of school attendance and labor force participation to malaria, which helps keep them poor.)
Re:Bed Nets (Score:4, Insightful)
No, because at some point in the day you have to get up and live life. At any point therein, you could get a mosquito bite.
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From the article:
Prof Adrian Hill of the Jenner Institute, Oxford, said he was pleased and encouraged by the EMA's decision but added that the vaccine was not a "magic bullet".
He said: "A bed net is more effective than this vaccine, but nonetheless it is a very significant scientific achievement.
While research into a vaccine is great, why haven't we focused efforts on supplying bed nets for everyone? I'm assuming that they'll cost less than the vaccine per unit and they also have the advantage of being reused.
Why aren't the locals buying bed nets themselves?
Supposedly $5 gets you an insecticide treated bed net that's good for 2 years [cdcfoundation.org], I know we're talking about very poor people but that sounds like somewhere where'd I'd expect a local industry to pop up.
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http://www.ted.com/talks/esthe... [ted.com]
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From the article:
Prof Adrian Hill of the Jenner Institute, Oxford, said he was pleased and encouraged by the EMA's decision but added that the vaccine was not a "magic bullet".
He said: "A bed net is more effective than this vaccine, but nonetheless it is a very significant scientific achievement.
While research into a vaccine is great, why haven't we focused efforts on supplying bed nets for everyone? I'm assuming that they'll cost less than the vaccine per unit and they also have the advantage of being reused.
Why aren't the locals buying bed nets themselves?
Supposedly $5 gets you an insecticide treated bed net that's good for 2 years [cdcfoundation.org], I know we're talking about very poor people but that sounds like somewhere where'd I'd expect a local industry to pop up.
From the sentence that is literally the one irght after the sentence that contains the price of the bed nets: "Unfortunately, this cost is too high for most families in poor rural African communities who survive through subsistence farming."
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Why aren't the locals buying bed nets themselves?
I'll guess extreme poverty is the reason, but they're not going to be buying the vaccines either, so it seems like we should be spending money on the bed nets as the cost-benefit ratio is going to be better. That doesn't mean we can't or shouldn't also do vaccination where possible, but it seems like from an economic point of view, the bed nets are what aid money or humanitarian groups should be focusing on.
Re:Bed Nets (Score:5, Insightful)
the bed nets are what aid money or humanitarian groups should be focusing on.
Vaccines work on uneducated people, and they work 24/7. Bed nets do not. People can use bed nets improperly, divert them for other uses (such as fishing nets), or just not use them at all. The bed nets need to be replaced every two years, as they fray, and the pesticide wears off. They offer no protection during most of the day, when people are working, and going about their lives.
Why do you assume the vaccine will cost more than the bed nets? TFA says nothing about cost. Vaccines that do not require refrigeration can often be delivered very cheaply. Oral polio vaccines cost a few cents per dose.
The problem is getting people to use them (Score:2)
Why aren't the locals buying bed nets themselves?
A variety of reasons. In places nearly half the population refuses to sleep under them. Sleeping under one is hotter than without and in some places this can matter. The nets sometimes get mis-used (like as fishing nets). Some people don't believe that the mosquito is the cause or the only cause. They are (rightly) seen as uncomfortable to use and provide only partial protection at best. Sometimes people don't trust the folks handing them out. They also eventually wear out.
I know we're talking about very poor people but that sounds like somewhere where'd I'd expect a local industry to pop up.
The problem is less getting
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It should also be noted that bed nets can be rendered ineffective by such things as rolling over or throwing an arm out in your sleep. If the net is touching the skin, the mosquitoes can bite right through it. Proper use requires a good bed and a well-built house, so that you can suspend it around the bed. (And the bed can't be overloaded - if there are several people in the bed you're more likely to touch the sides of the net.)
Bed nets are common in the areas affected. But they are finicky, annoying, a
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This is sub Saharan africa we are talking about where people go to the local witch doctor to get a potion based on body parts of albino's on the promise of wealth, success and power . You think they are going to believe that a mosquito bit causes Malaria?
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There are many groups doing just that including the WHO and many nonprofits. The difficulty as Wikipedia points out is a lack of education by locals who either don't use them or misuse them. They're often made into fishing nets instead of the intended purpose.
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Bed nets are a stop gap measure (Score:4, Insightful)
While research into a vaccine is great, why haven't we focused efforts on supplying bed nets for everyone?
Because bed nets merely mitigate the problem, not solve it. Bed nets are a good thing but they are merely a stopgap and nobody can live inside them at all times. Mosquitoes don't just bite at night when you are in bed. Anyway there are groups (including the CDC and WHO) who have spent considerable effort and money distributing bed nets.
I'm assuming that they'll cost less than the vaccine per unit and they also have the advantage of being reused.
Would you rather sleep under a bed net for your entire life or would you rather be vaccinated and not have to worry so much about the disease?
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Because people in the region often lack accomodations to use bed nets. Remind yourself of poverty levels in affected regions. Having a warm bed is a luxury many cannot afford.
A huge win if it really works (Score:3)
Even a vaccine that just reduces the devastation this disease causes is a huge win. The impact of this disease on affected areas is almost impossible to over state. Cutting the number of cases by a third is still hundreds of thousands of lives saved.
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Mosquitoes infect people with malaria and we infect non-infected mosquitoes when they feed off an infected person. Less infected people should equal less infected mosquitoes, which should mean even less infected people.
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The key problem with this vaccine is that it only reduces a child's chance of getting malaria by one-third.
What strain is it targetting? Is it possible that it's highy effective against one strain but not a different strain. If that's the case then a couple more targetted vaccines and you could have complete broad coverage.
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i heart dichloro-diphenyl-trichloroethane in brief (Score:3)
Yay for vaccine, some day, even for infants.
Yay for FREE mosquito nets.
But you do realize however... these are measures that we --- the countries who have already eradicated Malaria --- would not tolerate, if WE were as affected as they?
THE WHITEWASHED VERSION OF HISTORY
You're living it. Most people have no real perspective on DDT at all, it is simply something evil which allowed persons in developed countries which had already eradicated Malaria to claim its discontinuance as "the greatest environmental victory for everybody, ever"... though actually, taking lead out of gasoline was the real greatest victory. Most are too zero-tolerance enviro-Puritan even to consider a distinction between a light regimen of spraying walls inside homes versus the (mind bogglingly huge) agricultural applications throughout North America up to 1972, which everyone agrees was a bad idea. DDT is simply some 'evil banned substance'. Anyone talking about it is a loon. Anyone asking, where could they possibly get some is a subversive. It has come to this. That is the extent of this modern ugly.
THE UNWASHED VERSION OF HISTORY: BLOOD ON OUR HANDS
How do you calculate the value of 50 million lives, most of them in sub-Saharan Africa, most of them children? Sadly, you have to go to a politically motivated website to find this figure in proper context, and an an excellent summary of DDT's history [discoverthenetworks.org]:
"As recently as 2005, 500 million people around the world (approximately one-twelfth of the earth's population) were contracting malaria on an annual basis; and each year, 2 to 3 million of them died as a result. Since the 1972 U.S. ban on DDT, more than 50 million people--about 90 percent of whom resided in sub-Saharan Africa, and most of whom were children younger than five--have died of malaria. Said the World Health Organization, "more people are now infected [with malaria] than at any point in history," with "up to half a billion cases [being reported] every year." Anywhere from 1 to 2 million of those people die from the disease. Dr. Wenceslaus Kilama, chairman of Malaria Foundation International, placed this figure into perspective: "This is like loading up seven Boeing 747 airliners each day, then deliberately crashing them into Mt. Kilimanjaro." "The resurgence of a disease that was almost eradicated [many] years ago is a case study in the danger of putting concern for nature above concern for people," said Nizam Ahmad, a Bangladeshi analyst who focuses on the problems that affect developing countries.
Or find this Wayback New Yorker article describing the human triumph of malaria eradication [archive.org] that may well be from the point of view of DDT itself, for no other measure taken deserves near as much praise. Or this [wattsupwiththat.com] which cites a telling South African infection/mortality study with a particularly chilling graph.
Or the paper The Burden of Early Exposure to Malaria in the United States, 1850-1860: Malnutrition and Immune Disorders [2007] [nih.gov] which not only describes the direct impact of malaria in the United States, but also suggests some previously-unexplored side effects of such an endemic disease on populations that made life really suck. For example, "Union Army recruits who spent their early years in malaria-endemic counties were 1.1 inches shorter at enlistment due to malnutrition and were 13 percent more susceptible to infections during the U.S. Civil War as a result of immune disorders than were those from malaria-free regions."
I'm not bringing all this up because I'm trying to convince you that Malaria is bad. We know it's bad. But in the early 1970s something happened within the United States and