Dr. Salim Abdulla, Ifakara Health Research & Development Center, Tanzania 25 April 2007 Malaria, one of Africa’s oldest and gravest threats, may soon meet its match: a vaccine.
A malaria vaccine has long been considered among science’s greatest challenges and a distant dream. But, today, thanks to a remarkable discovery and a novel partnership, we could have an effective vaccine against malaria in just a few years’ time. Let’s mark this Africa Malaria Day by getting ready to adopt the vaccine and preparing to ensure that it reaches all our children in Africa.

The world’s most advanced malaria vaccine, RTS,S made history in 2004 when results from a trial of 2,000 young children in Mozambique showed that a vaccine could reduce severe malaria by 49%. Since severe malaria kills up to a million children a year and sickens millions more, even partial protection of this kind could save millions of lives -- a major public health victory.

An unusual partnership – linking a vaccine manufacturer, a foundation and African scientists – is working hard to make this vaccine available as soon as humanly possible. Right now RTS,S is in late Phase II trials at seven trial sites in Gabon, Ghana, Kenya, Mozambique and Tanzania. Next year, RTS,S will begin Phase III trials, the final stage in the clinical development process. If these tests continue to be successful the vaccine could be available as soon as 2012.

Africans are at the forefront of testing this vaccine for Africa. As one of the principal investigators of one of the clinical trial sites, I have witnessed the positive impact of the trial on African scientists, medical professionals and communities.

African scientists, working closely with the other partners, participate in the design of the clinical trial protocols, implement the protocols, and manage the day-to-day work of the trial. The investigators build strong working relationships with local communities and the parents of the children enrolled in the trials. We liaise with the Ministries of Health and other relevant local institutions regularly to update them on the progress of the trials.

The trials have also improved medical care provided in the communities. Our medical teams carefully monitor the health and progress of each child enrolled in the trial, often visiting them at their homes for check-ups. At each trial site, personnel receive training in the latest diagnostic and treatment procedures, and clinics receive new medical equipment. This benefits not only the children in the trial, but all the families and their children who use the local clinic.

I also serve as chairman of the Clinical Trials Partnership Committee, the coordinating and decision-making body for the vaccine’s development partners. The experience of working together with colleagues in Africa and around the world has enriched my knowledge – but it has also opened up new possibilities of cooperation within Africa.

Managing such an advanced clinical trial is no small task, and African scientists have risen to the challenge. This work has given me confidence that we have what it takes to implement a high-quality clinical trial for the benefit of humanity. Because of our success and the international recognition of this trial, Africa is now home to world-class science.

Personally, working on the clinical trials for RTS,S has been one of the greatest highlights of my professional career. Most investigators are lucky if they can say they worked on a trial that led to a new medical product. Even fewer investigators get to say they were a part of a trial that changed the course of medical history. This vaccine has the potential of allowing me to say both.

I have been fortunate to work on RTS,S for the last year, but the story of RTS,S begins much earlier. In 1987 a team at GlaxoSmithKline Biologicals (GSK) launched a major effort to invent a malaria vaccine. After a decade of repeated attempts, the scientists at GSK finally identified a promising vaccine candidate in 1999.

Shortly thereafter, GSK partnered with the PATH Malaria Vaccine Initiative, a non-profit organization supported by the Bill & Melinda Gates Foundation, to undertake clinical trials. This public-private partnership then evaluated and selected several leading African research institutions, mine among them, to carry out the on-the-ground work of the trials.

We, as Africans, now have another historic task: we must begin to prepare for a malaria vaccine now. It is up to us to help build the political will necessary to fund and distribute millions of doses of this vaccine. It’s not too early to start.

Today, on Africa Malaria Day, let us call on our communities, our leaders and on the international community to help complete this vaccine’s journey from the lab to the children who most desperately need it. A malaria vaccine is in our grasp for the first time in history. It’s about time.

Dr. Salim Abdulla is the director of the Bagamoyo Research and training Units of the Ifakara Health Research & Development Center in Tanzania.