From the field

World Malaria Day 2010

From the frontlines of African malaria vaccine research

By Tsiri Agbenyega, Principal Investigator, Agogo Presbyterian Hospital trial site
April 2010

AGOGO, Ghana – Malaria takes a devastating toll on communities in Africa. In Ghana, where I live, malaria is one of the most deadly diseases for children under the age of five—a relentless scourge. The impact of the disease is devastating, not just on the families upon whom it visits illness and death, but on the public health services and economies of sub-Saharan African countries.

In the war against malaria, we need all the weapons we can muster. On World Malaria Day 2010, we are marking a historic milestone: this past year saw the launch of a Phase 3 efficacy trial of the world’s most advanced malaria vaccine candidate in 11 research centers spanning seven African countries. There has never been a licensed vaccine against malaria. Phase 3 is the last big step for a vaccine candidate before submission for approval to regulatory authorities.

When beginning my studies in malaria research 15 years ago, I never dreamed I would be doing this work today. My colleagues and I never thought we would play a part in the development of a malaria vaccine or that we would come this far.

Back then, no vaccine candidate had shown efficacy in protecting against malaria. Research centers in Africa were not collaborating to conduct large vaccine trials, and there were few international partnerships pursuing malaria vaccine research.

This has all changed because many people never lost hope. Today, the once unimaginable is a near reality, and a malaria vaccine is within our reach.

RTS,S, as the candidate is known, has been in development for more than 20 years, including a decade of clinical research in Africa. Trial results have consistently shown that the vaccine candidate has a promising safety profile and could reduce the risk of malaria by half in young children and infants. In clinical studies, the vaccine candidate demonstrated that it can also be administered to infants along with standard childhood vaccines for measles, tetanus, diphtheria and polio.

Today, the trial is well underway in Burkina Faso, Gabon, Ghana, Kenya, Malawi, Mozambique and Tanzania. To date, more than 8,500 children and infants have been enrolled in the trial, of a total of up to 16,000 participants.

At the Agogo trial site, where I lead the RTS,S study, the project has opened up training opportunities for our young scientists to engage in pediatric medical research. At my institute and others in this trial, we increased our capabilities by building new facilities, installing sophisticated laboratory equipment and training our staff to use the latest technologies. At least as important, we have also been able to improve the level of care at the facilities where the studies are taking place. Providing state-of-the-art diagnostic tools has contributed to early diagnosis and appropriate treatment. We are doing a better job for our patients.

Ultimately, doing the best by our patients means preventing, not just treating, disease. We need to use every available tool to effectively prevent malaria, including bed nets, indoor residual spraying and environmental measures. Vaccines are a time proven means of prevention and we know that they have profoundly reduced the incidence of debilitating diseases such as polio and measles. Clearly, a malaria vaccine would complement our existing approaches and has the potential to save hundreds of thousands of lives.

Our African leaders now need to match our advances in research with similar advances in public health capacity and the political will required to widely implement the first ever malaria vaccine. We can make the promise of a malaria vaccine a reality if we maintain the momentum of this Phase 3 trial and begin to plan now for the future.

Dr. Tsiri Agbenyega is a Principal Investigator at the Agogo Presbyterian Hospital trial site, and former dean of the Medical School at the Kwame Nkrumah University of Science and Technology, Kumasi, Ghana. He heads the malaria research unit at Komfo-Anokye Hospital in Ghana. He was recently elected co-chair of the RTS,S Clinical Trials Partnership Committee, the group of leading African research institutions that, together with GlaxoSmithKline Biologicals (www.gsk-bio.com) and the PATH Malaria Vaccine Initiative (www.malariavaccine.org), manages the RTS,S clinical trials across the seven countries The Malaria Clinical Trials Alliance is also a contributor to the project.