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COVID-19 Vaccine Progress Could Mean Good News For Malaria Vaccine


We want to give you some positive news in the fight to vaccinate against one of the world's deadly diseases. And - drum roll - we are not talking about COVID-19. We are talking about malaria.

In 2019, there were 229 million cases of malaria worldwide. And one of the reasons it continues to be so hard to treat is that the one existing malaria vaccine is only about 30% effective. But - and here's the positive part - the scientific community's intense focus this year on a COVID vaccine, specifically, ones that use RNA like those developed by Pfizer and Moderna, could offer some lessons for malaria vaccine development.

Joining us now to tell us more about this is Dr. Pedro Alonso. He is the director of the Global Malaria Program at the World Health Organization, and he's joining us from Geneva, Switzerland. Dr. Alonso, thank you so much for joining us.

PEDRO ALONSO: Thank you for calling me.

MARTIN: So first of all, as I think we all know, we've all been consumed by the coronavirus pandemic for the last year. But, of course, there are other deadly diseases that have not stopped spreading. What is the state of malaria in the world right now?

ALONSO: So malaria has been around with humans probably for the last 10,000 years. And so we're talking of a very long history. The last 20 years have often been termed as one of unprecedented progress. In the first 20 years of this century, more than 7.5 million deaths have been averted. However, in the last four or five years, these downward trends have come to a halt. We've plateaued. And, of course, this is happening against a backdrop of population growth. For example, in sub-Saharan Africa, in the first 20 years of this century, population has doubled. And thus the implication of this is that today, we face about the same number of malaria cases in sub-Saharan Africa as we did 20 years ago.

MARTIN: So, you know, it's my understanding that, as we said earlier, that the one vaccine that is used is only something around 30% effective, and that even falls off after a few years. Could you just, as briefly as you can, tell us, you know, why the vaccine that does exist hasn't been more effective?

ALONSO: Yeah. Malaria is caused by four human plasmodium parasites. These are complex biological organisms. We still don't exactly understand the response of humans and the human immunity to this parasite. And thus the development of malaria vaccine is probably one of the holy grails of biomedical research. It is extraordinarily complex, much more so than the SARS-CoV-2 virus, which is, in relative terms, a very simple organism, a simple virus.

So biological differences are a massive reason. The second one, inevitably, is the amount of resources invested. So probably in the 10 months of 2020, in excess of $14 billion were invested in developing SARS-CoV-2 vaccines. The one vaccine that we have, RTS,S - that's taken 30 years to develop, probably all along received far less than $1 billion. So vaccines against malaria because they are targeted to some of the poorest sectors of our global community represent a market failure, and they therefore don't attract the type of resources that can be and are mobilized when the problem does affect other parts of the world.

MARTIN: To the issue of the resources devoted to this, it's my understanding that a team from Yale Medical School has developed a new model for a malaria vaccine that is based off of the RNA blueprint that the COVID vaccine uses. And understanding what you just explained to us about how these diseases are completely different, but could you explain in lay terms what an RNA vaccine is and how it's different from the other malaria vaccine that is currently in use?

ALONSO: Right. So the current vaccine, which is by and large what many other vaccines for other infectious disease builds on, is on recombinant proteins - so the production of proteins that represent parts of the organism, of the bot that you're trying to attack. RNA vaccines and its predecessor, which were DNA vaccines, which were also tested in malaria, use genetic material that transcribes - that is used to transcribe the information from the genome of an organism into the machinery that produces these proteins in the human cell.

I think it's been an amazing achievement to use RNA platforms to produce COVID-19 vaccines. And definitely this will need to be explored for other infectious diseases, and certainly for malaria. Are we optimistic? Possibly. But we - it is still unclear how with RNA technology one can induce the type of very high levels of antibodies that we know are going to be required if we want to protect against malaria.

MARTIN: Well, you're starting to answer the question I had, which is, are you optimistic? And it sounds as though you are. Can I ask you this? I don't know if you permit yourself thoughts like this, but I wonder if there's a part of this that is bittersweet for you? I mean, you've been working in the malaria space for years, and I heard what you said about the - kind of the level of resource and focus devoted to this one disease, which is, of course, you know, extremely - has been, you know, very deadly and very disruptive of people's lives and very frightening for people in, you know, many, many parts of the world, and versus, as you said, malaria, which has been around for thousands of years. And so is it - is there something bittersweet about the fact that progress is being made in part because of something else that affects people in other parts of the world? I don't know. I don't know if you entertain thoughts like that.

ALONSO: I do every day. But I don't allow myself to - the bitter component of the reaction dominate. But I'd like to take this as an opportunity. I think the world was starting to forget that infectious diseases are the one element in the area of health that could pose systemic threats to mankind. And COVID-19 has been an unexpected and stark reminder of our inevitable coexistence with microbes, with communicable diseases. And thus, I hope it will help remind the more developed part of our world, economically more developed part of our world, that the other half of the world lives permanently under the threat of the consequences of communicable diseases.

If COVID-19 helps us, A, refocus on infectious disease, regain our trust and the possibilities that vaccines can represent in the fight against infectious disease, and thirdly, show that when the world really gets serious about a problem, the transformative power of science and political will can change things in a very quick way, as COVID-19 is showing on the development of vaccines. So that is when the sweet bit comes into the equation. I think we have a golden opportunity, and the world must seize it. If we manage to control COVID, which I'm sure we will, this is the best example that we can do so with other diseases that affect the most poor sectors of our global community.

MARTIN: That is Dr. Pedro Alonso. He is the director of the World Health Organization's Global Malaria Program, and he joined us from Geneva.

Dr. Alonso, thank you so much for this information. Thank you for your hard work, and I do hope we'll talk again when there is yet more progress.

ALONSO: Michel, thank you very much.

(SOUNDBITE OF MUSIC) Transcript provided by NPR, Copyright NPR.

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