In Africa, there have been more deaths from malaria than from coronavirus in the past year. Almost half a million people died from malaria and 230 million new malaria infections were recorded in 2019 alone. Africa was home to 94% of these cases. Most of these deaths and new infections are in children. In fact, malaria is one of the leading causes of childhood mortality in Africa.
I have been part of medical mission trips to Africa many times before I retired from my medical career. The faces of children suffering from malarial fevers, limp in their mother’s arms from profound fatigue and weakness, or worse yet, seizing or in coma from cerebral complications still haunt my nightmares. Often, the best that I could do for these children was treat symptoms with chloroquine because of lack of availability of more effective drugs. If the child had severe cerebral symptoms, I could send them to a local hospital in hopes that they would receive needed life support. But even that was very limited. Often, if the mother brought an infant to me that was comatose, I knew that death was imminent and there was little I could do.
We passed out mosquito nets to everyone who came to our clinic—not a treatment but one of the best public health measures available. And every evening the medical team would detox—tell stories of patient encounters from that day, remind ourselves that even though the problem was more than we could even hope to tackle we were at least trying to do something—because the sense of frustration and inadequacy was more than we could handle alone.
Yesterday, in a pre-print study with The Lancet, a research team from the University of Oxford reported the trial results of Rs1/Matrix-M, after testing a low and high dose of the vaccine in 450 children from Burkina Faso. The vaccine was tested before peak malaria season and showed a 77% efficacy in the higher-dose group and 71% in the lower-dose group. The vaccine, even at high doses, was very well tolerated in the trial program with no serious adverse events reported.
This is a stunning development and raises hope that one of the world’s most deadly diseases could be brought under control. It has the potential to change the world as we know it and it brought such joy to my heart when I read the results. How many children’s lives might be saved by this? How much pain and suffering by little children might be alleviated by this?
I think the news flew under the radar for most Americans. We tend to be quite myopic and the coronavirus pandemic, the availability and deliverance of COVID-19 vaccine in our own country, has dominated our news cycle. As it should. After all, almost half a million Americans have died from coronavirus.
But malaria is a disease that has raged through humankind for centuries. Its probable arrival in Rome in the first century AD was a turning point in European history and some scholars believe it may have contributed to the fall of the Roman Empire. The development of quinine in the mid-19th century was another breakthrough that also contributed to global change. The Allies controlled Java and its valuable quinine stores during World War 1 and, as a consequence, German troops in East Africa suffered heavy casualties from malaria. Who knows how much of a factor this may have been in the war’s outcome?
Malaria, both epidemic and endemic, has plagued human civilization for centuries. An effective, well tolerated vaccine will create more of a global ripple effect than even the COVID-19 vaccines that we justly herald.
I hope I’m still around to see the light at the end of this infectious tunnel!