Malaria vaccine another success story for Jenner Institute team behind Covid jab
Tom Whipple, Science Editor | Francis Elliott, Political Editor
Saturday December 05 2020, 12.01am, The Times
Science
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Malaria, which can be spread through mosquito bites, is a far bigger killer in Africa than Covid-19
The Oxford team behind the coronavirus jab has taken a big step towards producing a cheap and effective vaccine for malaria.
The Jenner Institute said that it was due to enter the final stage of human trials with its vaccine, which it hopes could combat the almost half a million annual deaths, mainly in children.
“It’s going to be available in very large amounts — it works pretty well. And it’s going to be very low-priced,” Adrian Hill, director of the institute, said.
After promising early trials, the vaccine is going into the final-stage phase-three trials, where it will be tested on 4,800 children in five sites in Africa.
The announcement is the latest good news for British science after a month in which the team’s coronavirus vaccine proved successful in trials, and researchers at Deepmind claimed to have used machine learning to tackle the biological challenge of determining protein folding.
Professor Hill, who was working on the malaria vaccine for years, said that preventing the disease was a challenge on a par with Covid-19. “Malaria is a public health emergency. A lot more people will die in Africa this year from malaria than will die from Covid,” he said. “I don’t mean twice as many — probably ten times.”
The institute’s coronavirus vaccine is intended to be cheap and available at scale in developing countries. The same is true of the malaria vaccine. Despite more than a century of research, no vaccine is fully licensed for malaria. The only one that has reached this stage before, by the pharmaceutical company GSK, has only about 30 per cent efficacy and is being assessed in large-scale pilot trials.
The Oxford team believe there is a good chance that their vaccine will outperform that when it begins trials in Burkina Faso, Kenya, Tanzania and Mali next year. Early phase-two trials have shown promising efficacy, and Oxford has partnered with the Serum Institute in India, which has said it could make between 200 million and 300 million doses a year.
Professor Hill said that if the trial were successful, he anticipated the vaccine could be in use no later than 2024.
Malaria has been so hard to tackle with a vaccine in part because it is a parasite, many times bigger than a virus. Finding a target for antibodies to neutralise, which will also neutralise the parasite, has been extremely difficult. Natural immunity can be, for this reason, almost non-existent — which makes artificially induced immunity equally hard to achieve. Public health experts said that a truly effective malaria vaccine, or even one that performs better than GSK’s, could be a game-changer. “The Covid-19 pandemic has demonstrated the extent to which the world remains at threat from infectious diseases,” Azra Ghani, professor of infectious disease epidemiology at Imperial College London, said. “A highly effective vaccine against malaria could have a significant impact in reducing this risk.”
One reason Britain has been a leader in combating malaria is because of a government pledge in 2016 to spend £500 million a year on the disease. With cuts to the aid budget, public health experts fear that the funding could end. “We need the UK government to maintain its levels of funding to support malaria research so we can develop new solutions which are vital for ending the disease,” Professor Ghani said.
The Jenner Institute has been backed by the government, the EU, the Wellcome Trust and the Gates Foundation.
The Tory MP Andrew Mitchell, a former international development secretary, said he was concerned that without continued government funding Britain would not be involved in any distribution of the jab. “This is such exciting news — malaria kills a child every two seconds in the poorest parts of the world,” he said. “It would be a tragedy if cuts to the aid budget mean the UK fails to get the credit for delivering the full benefits of this amazing science.”
James Whiting, of the charity Malaria No More UK, said: “The Jenner Institute’s groundbreaking work on both the new Covid-19 and malaria vaccines demonstrates just how much humanity’s safety is dependent on new science, and the huge contribution British scientists are making to solve the world’s biggest problems.”
In a trial on young adult UK volunteers who were deliberately infected with malaria, it was more than 80 per cent effective.
A malaria parasite exists on the very cusp between the visible and the invisible, on the threshold where the micro becomes macro (Tom Whipple writes).
All year we have been fighting an infectious disease, and it has been invisible. The tests we have used to spot the coronavirus require cutting edge genetics, using devices of exquisite ingenuity — and all they actually “see” is a proxy for the virus.
A malaria parasite is different. With a microscope, you can watch it wriggling in a cell. This is an enemy that is, you would think, easier to defeat.
Yet with size comes other advantages. What the plasmodium parasite loses in stealth, it gains in robustness.
To attack a coronavirus, our body makes antibodies, little Y-shaped proteins that latch on to its surface. It does the same for plasmodium, but the firepower is diminished.
It is like hoping that an air rifle will take out a cow because it previously dispatched a squirrel. Extremely high levels of immune response are required to have a hope of defeating it.
In fact, it is worse than that. After we have beaten off an infection, our immune systems store antibodies that can spot and attack the same pathogen if it arrives again. This does not always work for malaria parasites. They can switch and change the proteins on their surface, disguising themselves.
This is why it has been so hard to make effective vaccines against malaria.
It is hard enough that Adrian Hill, director of the Jenner Institute, has been working on one since he first saw a malaria ward in Guinea, 30 years ago. It is hard enough that Sarah Gilbert, his colleague at the institute, has spent a chunk of her career on it too.
The Jenner Institute, based in a suburb of Oxford, made a coronavirus vaccine in a year: malaria has taken much of a lifetime, and it’s not solved yet.
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