A story within a story

It's easy to say mosquito. There are 3,500 species of mosquitoes, of which a few hundred are capable of spreading diseases. Mosquitoes indirectly kill because they cause toxins. If there were no mosquitoes these pathogens would not exist. Human history would also have been different, as many mass infections in the past resulted in events that changed its course. Mosquitoes have equipped themselves with these "biological" weapons of mass destruction: they are, depending on the case, viruses, worms, protozoa (parasites).

Let's think about malaria. The WHO 2019 world data is significant: 229 million the number of cases estimated in 87 countries endemic for malaria. 409,000 estimated number of deaths (including 274,000 children under 5 years of age - 67%). 1,200 deaths a day from this disease. Respectively 94% and 95% of cases and deaths in Africa.
The big news is that the WHO (World Health Organization) has called for the use of the newest anti-malarial vaccine for children. Technical complex name: RST vaccine, S / AS01 from the pharmaceutical company GlaxoSmithKline. In spite of the no vaxes and ni vaxes, the first major field check has finally been completed, in a largely positive way, in Ghana, Kenya and Malawi. The trial has involved 800,000 children since 2019, 2.3 million doses. Here is what is known today: the vaccine requires 4 doses. 3 to be administered 1 month apart, with a booster (fourth dose) up to approximately 18 months later.

When we say children we are talking about an age of 5/6/7 months: the most exposed to a fatal conclusion of the disease. Effectiveness: leads to a 30% reduction in severe disease. It prevents about 4 out of 10 cases of malaria; of 3 out of 10 cases in severe form. Reduces the number of children in need of blood transfusion to 1/3. It achieves a 70% degree of reduction in disease severity of hospitalization and death when used with antimalarial drugs. In short, a vaccine to be observed carefully and which is added to the others against infectious diseases. The cost is now between $ 5 and $ 10 per dose, about $ 30 per child.
Now the most affected states need to include vaccination in national malaria prevention programs. And be helped.

Climate change is also a problem in this respect because warmer climates can sustain entire populations of mosquitoes all year round. The Gates Foundation and other charities (e.g. the Global Fund to Fight AIDS / HIV) have been and are the main funders of the fight against malaria, by any means, including vaccine research, from part of other institutes other than those that have achieved a good result today. Among the questions to be solved with further research are, for example, the duration of their effectiveness and CRISPR techniques, of targeted gene editing. As always, things are never as simple as they appear. The vaccine must not deceive us that malaria is defeated, but there is an additional tool to use.


Carlo Degiacomi
NP November 2021