Betting on a malaria vaccine

The New England Journal of Medicine has a five page editorial on the hunt for a malaria vaccine.

Once a malaria vaccine is licensed, there will still be the problem of paying for it: the children who make up the potential market live in some of the world’s poorest countries. At the G8 Summit in Gleneagles, Scotland, this past July, representatives of donor countries expressed support for advanced purchase commitments to encourage vaccine development, and British chancellor of the exchequer Gordon Brown has promised that his government would pay £300 million to prepurchase a malaria vaccine if one is licensed. Last June, President George W. Bush also called on Congress to appropriate $1.2 billion in new funding over five years to reduce malaria deaths in Africa. Public health experts emphasize that even if a vaccine becomes available, reducing malaria’s toll will continue to require drugs, bed nets, mosquito-control efforts, and other measures. To be cost-effective, a vaccine would probably need to protect infants and toddlers for at least two or three years. Perhaps, during this period, episodes of low-level infection would allow children to develop longer-lasting natural immunity. “If [RTS,S] costs, say, $10 and it gives you three or four months’ protection, then that really is not a viable option,” said Brian Greenwood. Nevertheless, he and other veterans of the research effort say they feel more hopeful than ever before. Greenwood ventured a prediction: there will be a vaccine in use that gives at least partial protection against malaria by 2015, “but we don’t know which one it will be and whether it will be affordable.”