Finally! Malaria vaccine by Oxford; taking sting out of mosquito bite after 100 years of research and 1 billio - Times Now

The R21/Matrix-M pre-erythrocytic malaria vaccine candidate was developed at the University of Oxford (Oxford, UK) and is currently manufactured by the Serum Institute of India (Pune, India).

It is said that the colonising East India Company and later the British Crown lost more soldiers to the malaria epidemics in India's tropical climate than to war or battle here.

As per the World Health Organisation report, India, along with four African countries, had 95 per cent of the entire Malaria infection in the world in 2018. 4,50,000 people died due to Malaria in 2018.

But now, it is truly a Eureka moment as Rhys Blakely, Science Correspondent, The Times writes about how hopes have been lifted that millions of African children could be protected against malaria as soon as next year after a trial of a vaccine developed by Oxford University achieved "fantastic" results.

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The Times cites a Lancet release that announces that the jab gave small children in Burkina Faso up to 80 per cent protection against the disease. Experts believe that its use alongside existing measures, such as bed nets, could save hundreds of thousands of young lives each year.

"This is really exciting. People have been trying to make malaria vaccines for over a century," said Professor Adrian Hill of the University of Oxford.

"We think these data are the best yet in the field with any malaria vaccine. And very importantly, this is a vaccine that we think can be manufactured and deployed very widely . . . next year, we hope there'll be a significant rollout."

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The results, reported in the journal Lancet Infectious Diseases, ("Efficacy and immunogenicity of R21/Matrix-M vaccine against clinical malaria after 2 years' follow-up in children in Burkina Faso: a phase 1/2b randomised controlled trial"), suggest that the vaccine, R21, is on course to meet the World Health Organisation's goal of a vaccine with at least 75 per cent efficacy.

Oxford has partnered with the Serum Institute of India, the world's largest producer of vaccines. Hill said that the Indian company was "intent on manufacturing not tens of millions of doses, but hundreds of millions of doses of this vaccine when we get to scale, which may be reasonably soon".

Why did it take a hundred-year-long wait?

Greg Laden - a biological anthropologist and science communicator - writes that there are several reasons why there is no vaccine for malaria. Most importantly, malaria is not caused by a virus, nor by a bacterium. It's a protist that causes malaria. Generally speaking, there are not really vaccines for such organisms. Laden mentions a metastudy that looked specifically at Malaria had this to report: "... parasite-host interactions in the skin induce malaria-specific regulatory T cells, and subvert early antigen-specific immunity to parasite-specific immunotolerance. This ensures infection and tolerance to reinfection. Exposure to Plasmodium-infected mosquito bites therefore systematically triggers immunosuppression of endemic vaccine-elicited responses..."

The 2 important malaria vaccines:

But the breakthroughs in the vaccines engineered by the scientists now raise hopes.

1. The Oxford jab is one of two important malaria vaccines. The R21/Matrix-M pre-erythrocytic malaria vaccine candidate was developed at the University of Oxford (Oxford, UK) and is currently manufactured by the Serum Institute of India (Pune, India).
2. The other, called RTS, has been developed by GSK, the British-based drugmaker, and was recommended by the WHO for widespread use in children in sub-Saharan Africa last year. The vaccine, known as RTS, S was developed by GlaxoSmithKlein with the non-profit organization PATH over a 30-year period with support from the Bill & Melinda Gates Foundation and a network of African research centres. It is the world's first malaria vaccine that has been shown to provide protection against malaria in young children.

Malaria vaccines are not a silver bullet, though:

Sir Brian Greenwood, professor of clinical tropical medicine at the London School of Hygiene and Tropical Medicine, who has worked on both, said that differences in trials make it impossible to say which is better. He agreed, though, that Oxford's R21 looks likely to be made in greater quantities.

Dr Dave Knight who is an Occupational Health and Public Health physician at International SOS, a medical and travel security services company put the GSB vaccine's efficacy into perspective when he spoke to Forbes in 2019. For the GSB - Bill and Melinda Gates-pioneered vaccine that cost a billion USD over 3 decades, Dr Knight said: "While this new vaccine will undoubtedly reduce mortality in children in high-risk malaria areas, there are limitations due to the difficulty in maintaining durable protection after immunization. RTS-S is a subunit vaccine targeting specific surface proteins of the malaria parasite. This seems to result in a vaccine efficacy of around and in some cases less than, 50% of children vaccinated against the disease. The protective efficacy also seems to wane with time. However, there are a number of other malaria vaccines in the pipeline at various stages of development; some of which show promise. While this one may not be as efficacious as initially hoped for, it is definitely a step in the right direction and will help to reduce mortality in vulnerable children in high-risk areas."

How do the 2 malaria vaccines work?

Both vaccines use the same basic technique to train the body to fend off Plasmodium falciparum, the deadliest of the five parasites that cause malaria and the most common in Africa. They expose a child's immune system to a protein found on the outside of the parasite during the early part of its lifecycle.

This antigen is mounted on a hepatitis B protein. Together they form non-infectious virus-like particles. These are combined with a special adjuvant, a substance that further stimulates the body's defences.

Professor Halidou Tinto of the Health Sciences Research Institute in Burkina Faso, who led the Oxford malaria vaccine trial, said: "It is fantastic to see such high efficacy again after a single booster dose. We are currently part of a very large phase-three trial aimed at licensing this vaccine for widespread use next year."

The phase-three trial has recruited 4,800 children aged five to 36 months across four African countries. Results are expected this year.

The global malaria burden:

The World malaria report 2019 estimates that globally, there were an estimated 228 million cases of malaria in 89 countries. The estimated number of malaria deaths in 2018 stood at 405 000. Most malaria cases in 2018 were in:

the World Health Organization (WHO) African Region (213 million or 93%), followed by

the WHO South-East Asia Region with 3.4% of the cases and

the WHO Eastern Mediterranean Region with 2.1%.

India's fight against malaria:

In May 2015, the World Health Assembly endorsed the Global Technical Strategy (GTS) for Malaria Elimination 2016-2030, which lays down clear global goals, milestones and targets till 2030.

In accordance with the GTS, the Government of India launched the National Framework for Malaria Elimination 2016-2030 in February 2016 and the National Strategic Plan for Malaria Elimination 2017-2022 in July 2017 with WHO support.

India has a vision of a malaria-free country by 2027 and an elimination by 2030. WHO supported the country to accelerate malaria elimination activities in the states as per NSP 2017-2022.

WHO also lauds India's increased malaria prevention and control measures that have dramatically reduced incidents of malarial infection within the country.

How to prevent malaria:

Malaria is entirely preventable and treatable, says the WHO. The global health watchdog also recommends the use of long-lasting insecticide-treated nets (LLINs) for people at risk and indoor residual spraying (IRS) with insecticide to control vector mosquitoes. WHO lays emphasis on early diagnosis and complete treatment of malaria so as to help reduce the disease and prevent deaths, further contributing to reducing malaria transmission.

Disclaimer: Tips and suggestions mentioned in the article are for general information purposes only and should not be construed as professional medical advice. Always consult your doctor or a dietician before starting any fitness programme or making any changes to your diet.

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