The development of another malaria vaccine by US scientists calls to question efforts being made by Nigerian stakeholders, writes Bukola Adebayo
A group of scientists from the Vaccine Research Centre at the National Institutes of Health, in Maryland, United States earlier this month broke the news. According to them, they have found a vaccine, PfSPZ, that could protect 12 of every 15 persons from getting malaria infection. As a result, many people across Africa, known to be the ‘base’ of the disease, received the news with enthusiasm.
Of course, they have every reason to celebrate the feat knowing that malaria is one of the highest killer diseases on the continent. In fact, statistics have it that the disease kills over 600,000 persons annually in Africa, and parts of Asia.
In Nigeria, records also show that malaria kills about 300, 000 children under the age five and 7,000 pregnant women annually. Nigerians also spends about N480m for the treatment of malaria annually. So, for stakeholders, especially medical practitioners, the accomplishment is a welcome development as they want to see a turnaround in the health status of their people.
As stakeholders celebrate this, the lead author of the research, Dr. Robert Seder, insists that the results of the clinical trial of the vaccine done in about 57 persons in the US are very promising in the fight against malaria.
Seder, in an article in Journal of Science, said though the method they used could be regarded as unusual — as it involved injecting live but weakened malaria-causing parasites directly into the patient’s blood stream to trigger immunity — the result was 3 per cent effective.
Throwing light into their approach, Seder said they took lab-grown mosquitoes, irradiated them and then extracted the malaria-causing parasite (Plasmodium falciparum) and injected it into the bloodstream of 57 persons, who had never had malaria before.
The team, he added, found out that only three of every 15 persons given the highest dosage of the vaccine contracted the infection after exposure to malaria.
Seder said, “We are excited and thrilled by the result, but it is important that we repeat it, extend it and do it in larger numbers.
“It allows us in future studies to increase the dose and alter the schedule of the vaccine to further optimise it. The next critical questions will be whether the vaccine is durable over a long period of time and can the vaccine protect against other strains of malaria.”
Apart from this vaccine, scientists in developed countries, where a negligible fraction of their citizens contract malaria, have developed over 20 vaccines still in trial. Indeed, they are working hard to find a solution to a disease that is ravaging Africans — not Americans.
According to the 2010 World Malaria report of the World Health Organisation, Africa is home to more than 80 per cent of malaria infections and deaths in the world.
The report read, “Most malaria deaths occur among children living in Africa where a child dies every minute from the disease. The Democratic Republic of the Congo and Nigeria account for over 40 per cent of the estimated total of malaria deaths globally.”
Though medical experts in Nigeria have commended the efforts of the scientists at the US institute, they also question why medical solutions to the disease that is killing more Nigerians and other Africans should be coming from abroad.
Appraising the development, the National President, Association of General and Private Medical Practitioners of Nigeria, Dr, Anthony Omolola, linked it to what he called the “curious situation” to poor funding of research institutions.
He also blamed it on the lack of political will on the part of the government. According to Omolola, until there is adequate research funding on malaria prevention and control, Nigerian scientists may not able to find a homegrown solution to the disease.
He said, “That scientists abroad are fighting diseases killing Nigerians is not a new thing. In fact, we are getting used to it. They are virtually seeking solutions to many of our health problems. HIV is killing people. It is these same scientists with the financial and moral backing of their governments that are seeking a solution to stop it.
“Agreed, malaria is killing thousands of Nigerian babies and pregnant women but we cannot blame our scientists. The blame should be heaped on the government that is not doing much to fight it.”
Beyond this, he noted that many research efforts by Nigerian scientists had been frustrated due to no funds.
Omolola added, “Our research institutions are poorly funded. In fact, it is a reflection that government is not making enough budgetary provision for the health sector. There is no political will to provoke appropriate funding.
“There was a time in this country when every research institution focused on malaria control and prevention because the government then was concerned. They launched massive and aggressive initiatives to break the back of malaria but unfortunately that is no more.”
Omolola, who acknowledged that the country had national malaria control policy, frowned on its provisions, implementation and enforcement. The policy, according to him, is too weak.
He added, “It is not until we get a vaccine that we can eradicate malaria in Nigeria. We know what makes mosquitoes breed in Nigeria, the lack of drainage channels, bushes and dirty environment and poor sanitary conditions.
“If government puts its feet and money down that we are going to be fumigating every home; have good drainage systems and ensure that citizens keep their environment clean, then, we can say we have a leadership that wants to prevent its citizens from dying from a disease that is preventable and curable.”
Other stakeholders warn that delay in finding an indigenous breakthrough to malaria control is dangerous for Nigeria economically. A professor at the Department of Pharmacy, University of Lagos, Olukemi Odukoya, is one of them.
Speaking at a recent forum on Traditional Medicine in Nigeria, he said that there was the need to explore the use of herbs, plants and natural medicine in the prevention and control of malaria.
Odukoya, an apostle of the use of herbal medicines in orthodox treatment, also urged the government to defer all international pressure and embrace herbal medicine, which she said, was more cost-effective and available in the country.
She said,” We have many researches going on in Nigeria, on herbal medicine, plants. Agbo is effective in the prevention and treatment of malaria.
“However, is the government ready to incorporate it into the country’s health care policy? Will the authorities shun international pressure and do what is right? When will the government approve the use of herbal preparations in the treatment and prevention of malaria in hospitals? Will doctors recommend it?”
Odukoya added, “Malaria medications are got from plant-based sources which we have in abundance in Nigeria. It will be cheaper for government to sponsor herbal researches. It will be more affordable for the citizens.”
Also speaking on the efficacy of herbal preparations in the treatment of malaria, a question that is always posed by professionals on this aspect of medicine, the university teacher also called for a proper national policy on health.
According to her, the government can ensure the safety of traditional and herbal medicines by regulating the practice.
She said, “When there is no national guideline or policy on herbal use quacks are free to sell chalk or coloured water and claim it is a herb that treats malaria. This silence is exposing Nigerians to fake herbal medicines. But we must make no mistake about it. Nigerians still believe strongly that there is power in leaves and herbs.’
However, the Vice-President, Commonwealth Medical Association, Dr. Osahon Enabulele, looks at the issue from a different perspective. He believes that Nigerian scientists still have a lot to do in ensuring that the country develops an indigenous vaccine.
He said, “Scientists and researchers in Africa and Nigeria should focus on malaria. They can replicate the research done by the US scientists in Nigeria. They can even go further as we have the resources to conduct clinical trials on malaria treatment that we discover.”
But for the coordinator, the National Malaria Control Programme, Dr. Nnenna Ezeigwe, the FG is not relenting in its efforts to lift the health sector to loftier heights.
The government, she said, subsidised the cost of anti-malarial drug such as Artemisinin Combination Therapy by 75 per cent, and plans to distribute more than thirty million Insecticide Mosquito Treated Nets for children and pregnant women this year.
Ezeigwe added, “We would not stop doing what we are doing currently to prevent malaria, including use of long-lasting insecticide treated bed nets, appropriate treatment using malaria test kits in our hospitals and intermittent prevention in pregnant women, and other environmental measures we are taking.
“There are already 20 vaccines in line, including this one. If the ones we think would be successful prove not to be so, we would be hopeful that the others might be okay, knowing that we have others to access. We applaud the research but it does not mean we are going to sleep.”
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