Malaria’s eradication is a long way away

The ideas and innovators shaping health care

Oct 07, 2022 View in browser   By Carmen Paun, Ben Leonard, Ruth Reader and Grace Scullion WEEKEND READ A malaria vaccine is readied in Malawi. | Jerome Delay/AP Photo The arrival of the first malaria vaccines is raising hopes that the disease, which killed nearly 630,000 people globally in 2020, most of them children under 5 in sub-Saharan Africa, can be eradicated, the New York Times reported this week. The story laid out the challenges, including overcoming the logistical troubles of distributing vaccines, drugs and bed nets across rough terrain in African countries; balancing other health priorities; and overcoming misinformation that often surrounds the deployment of new vaccines. The vaccines: The World Health Organization recommended the first vaccine against malaria a year ago. More than three decades in the making, Mosquirix cost over $200 million to develop and is the world's first vaccine against a parasite-driven disease. But it's 30 percent effective in preventing hospitalization, and it probably won't reach African children until late 2023 because of severe supply constraints. Experts are betting on a second vaccine a University of Oxford team is developing. Its malaria shot has shown efficacy of up to 80 percent in clinical trials and could be a game changer, but it's still at least a year away. And even more preventive tools are being developed: an mRNA vaccine from BioNTech, the German company that worked with Pfizer on its Covid-19 vaccine, and monoclonal antibodies that can prevent malaria for at least six months. Beyond shots: Mosquitoes spread the disease, so killing them is part of the solution. Bed nets coated with long-lasting insecticides or chemicals that paralyze mosquitoes are in the making. Researchers at Imperial College London genetically modified mosquitoes to prevent them from transmitting malaria. And one early-stage clinical trial used mosquitoes to deliver an experimental malaria vaccine, NPR reported. A lack of resources: Gavi, the international vaccine alliance, committed $155 million to the deployment of Mosquirix, and UNICEF granted vaccine manufacturer GlaxoSmithKline a $170 million contract to produce 18 million doses over the next three years. That's far from the 100 million doses estimated to be needed yearly. Abdourahmane Diallo, the former CEO of the Roll Back Malaria Partnership, has pointed to a $2.6 billion funding gap for malaria prevention tools. The Global Fund to Fight AIDS, Tuberculosis and Malaria, which funds bed nets and medicines, fell short last month of its fundraising target of $18 billion for the next three years. Instead, it got commitments of $14.2 billion, nearly the same as three years ago. Logistical problems: Mosquirix must be given in four doses, between ages 5 months and 18 months, but many parents in Africa struggle to take their children to a clinic. Vaccine mistrust also runs high. In one survey , about half of the people in Niger and the Democratic Republic of Congo said they wouldn't trust a malaria vaccine. Our take: Malaria's eradication is a long way off. The drive to eradicate polio, for which vaccines have existed for more than six decades, began 35 years ago.   JOIN NEXT WEDNESDAY FOR A TALK ON U.S.-CHINA AND XI JINPING'S NEW ERA:  President Xi Jinping will consolidate control of the ruling Chinese Communist Party later this month by engineering a third term as China's paramount leader, solidifying his rule until at least 2027. Join POLITICO Live for a virtual conversation hosted by Phelim Kine, author of POLITICO's China Watcher newsletter, to unpack what it means for U.S.-China relations. REGISTER HERE.     WELCOME TO FUTURE PULSE This is where we explore the ideas and innovators shaping health care. Can CRISPR cut HIV genes out of human DNA? Clinical trials are testing to see if removing the parts of the HIV genome responsible for viral replication could eliminate the virus, saving patients from having to be on antiretrovirals for the rest of their lives. Share news, tips and feedback with Ben at bleonard@politico.com, Ruth at rreader@politico.com, Carmen at cpaun@politico.com, or Grace at gscullion@politico.com.  Send tips securely through SecureDrop, Signal, Telegram or WhatsApp.   TUNE IN TO THE PULSE CHECK PODCAST: Keep your finger on the pulse of the biggest stories in health care by listening to our daily Pulse Check podcast. POLITICO's must-listen briefing decodes healthcare policy and politics, and delivers reality checks from health professionals on the front lines. SUBSCRIBE NOW AND START LISTENING.     TWEET STORM Vivek Murthy | Susan Walsh/AP Photo President Joe Biden wanted to demonstrate America's renewed commitment to international cooperation on health when he nominated Surgeon General Vivek Murthy to the executive board of the World Health Organization this week. But the reaction in the Twittersphere wasn't as positive as Biden wanted; some in the public health world saw a slight to Loyce Pace, the assistant secretary for global affairs at the Department of Health and Human Services. Pace has been the administration's face on the WHO executive board. Twitter Pace is the first woman of color to hold the job. Twitter The White House called Murthy a "renowned physician, research scientist, entrepreneur and author," and noted his path-breaking status as the first surgeon general of Indian descent. Murthy's nomination is part of Biden's efforts to repair the U.S. relationship with the WHO following former President Donald Trump's decision to disengage from the international body to protest its handling of the Covid-19 pandemic. The White House told Future Pulse the U.S. has two roles at the WHO, the one Murthy will fill if he wins Senate confirmation and Pace's role as U.S. delegate. Pace isn't eligible to sit on the WHO board on a permanent basis because U.S. rules require U.S. board members to have medical degrees with at least three years of practice experience. That didn't go over well with some Twitterati. Twitter   Follow us on Twitter Ben Leonard @_BenLeonard_ Ruth Reader @RuthReader Carmen Paun @carmenpaun   Follow us

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