Good news for World Malaria Day!

25 Apr

Today we celebrate World Malaria Day. Every year, 3.2 billion people are at risk of contracting malaria. This leads to about 198 million malaria incidents and an estimated 627.000 deaths. Those living in the poorest countries are the most vulnerable to the disease. It’s in Africa that malaria takes epidemic proportion. According to the WHO, 90 percent of the estimated global malaria deaths occurred in Africa. Between them 62% are children aged under 5. Despite West propaganda and public opinion ignorance malaria is one of the first cause of death in the Continent with Tuberculosis. Comparing to malaria HIV/AIDS became an irrelevant problem.

Malaria is a disease caused by a parasite called Plasmodium, transmitted through bites from infected mosquitos and is an endemic sickness in several countries. Symptoms of malaria include fever, headache, and vomiting, and usually appear between 10 to 15 days after the mosquito bite. If timely treatment is not provided, it rapidly becomes life-threatening because it disrupts the blood supply to vital organs.

The pandemic has a devastating socioeconomic impact on African countries causing poverty because of absenteeism from work and school, thereby rendering children unequipped for promising careers. African governments spend trillions of dollars to prevent and treat malaria. Unlucky these funds are not enough so they are forced to ask Aid Agencies intervention, increasing their political and economic dependence to West. Despite their efforts African governments are often criticized by West academics and accused to don’t do their best.

The main interventions for controlling the spread of malaria include the prompt and effective treatment with artemisinin-based combination therapies; use of insecticidal nets by people at risk; and indoor residual spraying with insecticide to control the vector mosquitoes. Since the first research in 1987 the International Scientific community has not yet discovered a Vaccine.

Anyway good news had reached the African public opinion just some weeks ago. GlaxoSmithKline has terminated the phase 3 (human experimentation) of its vaccine RTS,S/AS01, the first malaria vaccine able to reach advanced trials with success. 16,000 children has vaccinated with RTS,S/AS01 in seven African countries: Burkina Faso, Gabon, Ghana, Kenya, Malawi, Mozambique and Tanzania. The campaign, started on October 2005, has meanly target children aged 5-17 months assuring an effective coverage between 46 and 30%. The RTS,S consists in a sequence of two circumsprozoite proteins and the hepatitis B surface antigen (HBsAg) that intracellularly and spontaneously assemble into mixed polymeric particulate structures that are each estimated to contain, on average, 100 polypeptides.

Knowing that the parasite has mastered the art of eluding the human immune system, researchers behind the vaccine, known as RTS,S, focused on the form of the parasite that is injected by the mosquito. They have fused a portion of one of the main surface proteins to a surface protein of a virus that the body can more readily recognize, in this case the hepatitis B virus surface protein. The hypothesis is that this would help to stimulate the immune system to prevent infection by the malaria parasite before it escapes the liver and breaks out into the blood. Alongside that, there is an “adjuvant” system to boost the immune response, significantly increasing the levels of antibodies that can block infection of liver cells and harnessing T-cells to attack any parasites that may escape and go to ground in the liver.

Prof. Brian Greenwood, study author and professor of clinical tropical medicine at the London School of Hygiene and Tropical Medicine declares a little disappointed by the results of the clinical trials. Anyway he explains that it will be impossible at the moment to reach the success seen in measles vaccines with 97% efficacy. This it’s due of the particularities of Malaria parasite present in mosquitoes that is genetically complicated. It has a very complicated life cycle and it has learnt how to evade the immune system over hundred of years. European Medicines Agency and WHO if satisfied about the experimentation data could licensed RTS,S/AS01 on August allowing to GlaxoSmithKline to commercializing the vaccine starting from October of this year.

WHO wants give priority of immunization campaing to Africa and a controversy has already come out about who must pay the cost. African Union intend request to U.N and International Community a 100% free immunitation for the children aged under 5. The request seems supported by Roll Back Malaria Partnership an umbrella organization of 500 partners (Worldwide endemic countries Representatives, non-governemental organization, international research institutions). GlaxoSmithKline has not yet pronounced herself on the matters. Several observer will find difficult that the famous pharmaceutical company will allowed to a free immunization in Africa after the failed vaccine of Ebola discovered by Italian researchers from Napoli. The research has cost millions of dollars without tangible results in the three African countries victims of the recent Ebola epidemic. As usually business and human life protection duty are difficult to conciliate.

Fulvio Beltrami
Kampala, Uganda
@Fulviobeltrami

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