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>How the Gates Foundation plans to beat malaria without the vaccine
GATES FOUNDATION MOVES ON FROM FIRST MALARIA VACCINE — The development of the world’s first malaria vaccine was a historic milestone, making worldwide headlines last fall.
Despite its 30 percent efficacy against hospitalization with severe malaria in young children — dispelling hope that it would be a silver bullet — there was widespread enthusiasm that the vaccine could help prevent the deaths of 400 children for every 100,000 fully immunized kids.
Since 2001, the Bill and Melinda Gates Foundation has donated more than $200 million to be used for testing the RTS,S vaccine. Global health organizations then piloted it in Ghana, Malawi and Kenya.
Mass rolloutwas always going to be challenging.
Citing the shot’s low efficacy, short-term immunity, high price and limited supply, the Gates Foundation decided not to support the vaccine rollout directly, and said it supports the decision by Gavi, which funds vaccine procurement for developing countries, to fund the RTS,S vaccine program.–
“Although we had spent a lot of money on RTS,S directly, when we ran through our analyses and said: ‘What saves the most lives today and what is the best use of R&D and product development money and product launch money for the rest of this decade, we ended up moving in a different direction,” Philip Welkhoff, director for malaria at the Gates Foundation, told Global Pulse. He called the decision challenging.
Accelerating the development of second-generation bed nets to improve protection from malaria-transmitting mosquitoes and supporting the deployment of other tools, such as drugs and insecticides, needed to fight the disease will save more lives with the available resources in the short term than the vaccine,he said.
What happens now: Gavi has allocated some $155 million to support the vaccine’s rollout over three years. The first application window for interested countries is expected to open next week, and the World Health Organization will lay out fair-vaccine-allocation advice in the next few days.
What the Gates Foundation is eyeing next: The development of the RTS,S vaccine yielded knowledge, Welkoff said, that could lead to a more powerful tool to fight malaria: monoclonal antibodies.
The drug therapy is under development and could become available toward the end of the decade, he said. The aim is to protect children most at risk from malaria with one injection ahead of the rainy season when malaria transmission is highest.
Instead of the three-dose RTS,S vaccine, “you could just come in every year, ahead of the season, have a single encounter with the child and protect the child for at least four months and as much as five or six [months],” he said.
Until then, countries in sub-Saharan Africa will have to rely on Gavi and their own resources to access the world’s first malaria vaccine.