NextBillion - An Initiative of the William Davidson Institute at the University of Michigan

Wednesday, July 15, 2015

It’s a showpiece drug that has the potential to end a disease that kills half a million African children a year. Yet even before it wins a license, the world’s first malaria vaccine has lost some of its sheen.

Backed by billionaire philanthropist Bill Gates and developed by GlaxoSmithKline, the vaccine — called RTS,S or Mosquirix — is being assessed by regulators and global health authorities.

Granting it a license and recommending it for rollout in sub-Saharan Africa, where malaria kills one child almost every minute, ought to be a no-brainer.

But Mosquirix is hampered by caveats, complexities and cost implications that threaten to make its arrival on the global health stage more of a problem than a solution, possibly not just for malaria but for vaccines in general.

“There’s a lot of excitement for a malaria vaccine. But it’s a very complicated vaccine, so the recommendation is presumably going to be complicated too,” says Seth Berkley, chief executive of the GAVI global vaccine group.

Malaria is caused by a parasite carried in the saliva of mosquitoes. GSK’s vaccine is designed to go to work at the point the parasite enters the human bloodstream after a mosquito bite.

By stimulating an immune response, it can prevent the parasite from multiplying in the liver. Without that response, the parasite re-enters the bloodstream and infects red blood cells, leading to fever, body aches and sometimes death.