ANDREA SEABROOK, host:
From NPR News, this is ALL THINGS CONSIDERED. I'm Andrea Seabrook.
As President Bush continued his African tour today, he won praise from Tanzania's president for U.S. help in fighting HIV/AIDS and malaria. Among the U.S. projects in Africa are malaria vaccine studies conducted by the National Institutes of Health involving the Malinke people of Mali.
Reporter Addie Goss recently visited an NIH-funded facility in the village of Bancoumana.
ADDIE GOSS: Bancoumana wakes up to the sound of women pounding millet outside their mud huts. During the rainy season here the rice fields are flooded, mosquitoes are born, and malaria is like the flu - everybody gets it. Modibo Jabate(ph) is a griot, a kind of village journalist. In Bancoumana he says there's a severe form of malaria that kills the children. The Malinke call it cono(ph), which means bird.
Mr. MODIBO JABATE: (Through translator) The child convulses. He opens his eyes wide and screeches. It's like a bird has seized him.
GOSS: There's a small health clinic here but it can take people days to gather the few dollars for prescriptions. So until recently, most parents brought their sick children to the village healer, who gives them traditional medicine. They pay him in cola nuts.
Mr. JABATE: (Through translator) People were at the mercy of the mosquitoes. Many children never reached ten years.
GOSS: Then about 15 years ago a Malian doctor came to Bancoumana to study which strains of malaria were making kids sick. His name is Ogo Baradumbo(ph), or Ogo, and the griot Jabate remembers that from the start Ogo saved lives.
Mr. JABATE: (Through translator) He went to families and he asked, Madame, what brings malaria? There were some who said it was cold water, some who said it was the mangoes. And Ogo said, no, it's mosquitoes. You have to protect yourself, clean your yard, sleep under a mosquito net. Don't let containers of water sit around.
GOSS: A few years ago the Malian Dr. Ogo got a grant from the U.S. National Institutes of Health to start testing a malaria vaccine in 300 children here. Over time that grant helped build a medical research center in the middle of Bancoumana. They built it side-by-side with the local clinic, which didn't even have water or electricity. Ogo says parents signed their kids up for the vaccine trials, partly as a mater of village pride.
Dr. OGO BARADUMBO: They think they have opportunity to participate in the international challenge of developing a vaccine to save the life of thousand and millions of kid. Really, the first volunteer I have had (unintelligible) they say if you get the vaccine - the will say Bancoumana was the first village. That makes them very proud, I can tell you.
GOSS: There would be two groups of children. One would get a shot containing the experimental malaria vaccine; the other would get a shot of the control, a flu vaccine that had already been shown to be safe. The experimental vaccine had been tested for safety in adults in Mali and in the United States with no significant problems.
But the only children who had received a vaccine were 36 kids in another village. This raises questions for ethicists like Lawrence Gostin at Georgetown Law School. He says ideally you don't want to give vulnerable people like the Malinke anything that hasn't first been proven safe in children in the developed world.
Professor LAWRENCE GOSTIN (Ethicist, Georgetown Law School): Questions of is there an undue incentive, do the parents really understand, is there the same culture, all loom very large.
GOSS: But the NIH-funded researchers say they're doing everything they can to avoid exploiting the villagers. Most parents in Bancoumana are illiterate, so the researchers read them an explanation of what the vaccine is and what the risks are. And they take pains to make sure parents understand what they've been read.
Gostin says the bottom line is a malaria vaccine could save countless lives. And as they test it, NIH is providing desperately poor Malians with healthcare they wouldn't otherwise have.
Prof. GOSTIN: There are some ethicists that think that if you have a trial in a developing country, that you use exactly the same standards as you do in the United States. I don't believe that that's true because I think that if you take that standard, you end up not doing any service to people that are suffering desperately.
GOSS: The researchers treat any child enrolled in the study for any illness. Parents here say they've enrolled their children for just that reason because they can't afford to go to the village clinic. Then to make sure they're not coercing people, the researchers also provide some health services to villagers who are not participating in the vaccine trials.
(Soundbite of coughing)
GOSS: Like this little boy. His dad took him to the village clinic today and the doctor wanted to do some blood tests for liver failure. But the clinic doesn't have anything even close to a lab. So the doctor called the NIH-funded researchers and now the boy is at the research center having blood drawn for tests. The researchers do this for free.
(Soundbite of baby crying)
GOSS: Even the traditional healer, Nyana Afode(ph), says he's thrilled the researchers have taken his patients away.
Mr. NYANA AFODE (Healer): (Through translator) Before they came I never slept because everyone brought their sick babies to me. Now when a child comes here with a fever I send them to the researchers.
GOSS: The healer says this while sitting in bed in his hut. Over his head is a mosquito net the doctors gave him.
Another day ends in Bancoumana. Men and women walk back from the fields, and their children gather at the research center, one of the few places in town with electricity, to watch TV.
(Soundbite of music)
GOSS: For NPR News, I'm Addie Goss.
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