Green light? Go.
No piece of cake.
The road to a world without malaria is not iced like a cake with a layer of freshly whipped up asphalt. It has been a slow road with a rough surface and understaffed roadworks. It is a perpetually underfunded project, with scarcely enough sustainable funding to keep the wheels in motion, let alone pay for the repairs that have cropped up along the way. Medication resistance, mass refugee migration, climate change, and coincidental pandemics are just some of the potholes that have developed. Whilst recent decades have brought the speed limit up a little bit, efforts have plateaued, so that the odometer of achievement has ticked up constantly but agonisingly slowly.
Now, though? A little bit of good luck. A bright, green light.
A first time for everything.
On the 6th of October, the World Health Organisation announced that it had endorsed the first ever malaria vaccine for use in preventing infections amongst children. The inaugural approval came after a pilot study involving Ghana, Kenya, and Malawi that saw the inoculation of 800,000 children against the deadly and preventable disease. Here are the key findings from the project:
It ticks the box, reducing the rate of deadly malaria infections by 30% – even in areas where people already have access to other tools. It is going above and beyond.
It fills in the blanks, with a demonstrated effect of protecting children who don’t have an insecticide-treated bednet to sleep under. The vacine was able to cover more than two thirds of the children who fall into that category.
The vaccine can be feasibly delivered. Using existing frameworks to distribute immunisations, it can achieve equitable coverage of the most at risk populations, and has done so during the pandemic. Better yet, it actually increases the number of people who can access some form of malaria protection.
"This is a historic moment. The long-awaited malaria vaccine for children is a medical breakthrough for science, child health and malaria control... Using this vaccine on top of existing tools to prevent malaria could save tens of thousands of young lives each year"
- Dr. Tedros Adhanom Ghebreyesus (Director-General WHO)
Perfect is the enemy of good.
It’s an idea that we’ve become fond of at Borne Clothing, and it’s humbling to see the real meaning of the phrase in action: the malaria vaccine is not perfect, but a a 30% reduction in cases of life-threatening disease is huge. Reframed, that is as close to perfect as we have achieved after hundreds of years of trying.
A huge part of the difficulty in tackling malaria is that there is no one-size-fits-all solution. Insecticide-treated bed-nets, indoor residual sprays, and prophylactic medications are not a group of panaceas. Instead, they’re distinct parts of an intricate jigsaw puzzle that is still being completed. They’re like the corner pieces - they provide a framework for success. The beauty of this vaccine is that it complements the tools that have come before it. In fact, data from the pilot study demonstrates that layering tools can result in more than 90% of children benefiting from some form of coverage. Crucially, that reliance did not lead to changes in health-seeking behaviours, with no negative impact demonstrated by vaccine uptake on the use of other tools.
A long time coming, more time ahead.
Over hundreds of years, malaria has ravaged through almost every continent. This vaccine rests on the successes of science over the past 124 years, and is built on the back of over 30 years of research. The time scale of the mosquitos impact is vast, but the day-to-day reality is fleeting. Still, one child dies from malaria every two minutes.
This vaccine is a huge leap in the right direction. It brings us closer to a world in which children don’t just fall asleep in the safe knowledge that they won’t wake up with malaria, but in which malaria is a thing only of dreams and nightmares, a distant recollection of a previous era. It promises health, a better world, and more time.