Doctor: Malaria Vaccine Is Within Reach
MICHEL MARTIN, host:
I'm Michel Martin, and this is TELL ME MORE from NPR News.
Just ahead, new superheroes to root for - 99, in fact. We'll tell you why in just a few minutes.
But first, it's time for the next big thing. When you think of vaccines, you probably think of the flu or small pox, but not a solution for malaria. It's one of the world's deadliest diseases, and scientists have been working on a malaria vaccine for decades.
Now, a group of small clinics called the INDEPTH Network appears to be closer than ever. The network is headed up by Dr. Fred Binka, and it tracks the lives of almost two million people in developing countries. Dr. Binka joins us from Accra, Ghana.
Welcome. It's a pleasure to speak with you.
Dr. FRED BINKA (Executive Director, INDEPTH Network): Thank you. It's pleasure for you to have me.
MARTIN: Now, you're speaking to us from Accra, Ghana, which is the headquarters of one of INDEPTH's research centers, at Kintampo Health Research Center. What are you doing there specifically? What are you focused on there?
Dr. BINKA: What I focus on currently is trying to support the route of the science across Africa, to bring them up-to-date and to make sure they are preparing for a big vaccine trial that is coming next year on malaria, the malaria RGSS vaccine trial.
MARTIN: Many of us in the U.S., when we think about a health crisis gripping the continent, we think of HIV/AIDS. So if you were to talk to me about malaria, what is the scope of the problem of malaria in Africa?
Dr. BINKA: Malaria is still the most commonest cause of death, at least among children in Africa. It has the biggest burden and toll on children's survival in Africa today.
MARTIN: Even more than diseases connected to water, even more than gastrointestinal problems and so forth?
Dr. BINKA: Yes. With regards to children, and especially the malaria endemic areas, malaria is still number one, and the diarrheal disease and respiratory disease come second and third.
MARTIN: Where are we now with a malaria vaccine?
Dr. BINKA: I think we've made much progress now, at least in the malaria community. Today, we have a candidate that is in phase two trials. We are hoping to start phase three trials next year. So we've made much more progress compared to the other diseases like HIV and tuberculosis.
MARTIN: So could you put it in terms that I could understand, which is what's your best-case scenario from when there might be a usable vaccine?
Dr. BINKA: Yes.
MARTIN: Are we looking at a year, or two years?
Dr. BINKA: No, this is about four or five years to go. At the moment, we have a vaccine candidate that was shown that is protective in adults. We'll begin to show that it is protective in children. And we are conducting several trials to make sure we can have right dosage and to make sure it can be protective in the infants. We are just about to finishing that aspect of testing the vaccine, and now we will go to the next stage where we will try to document the protectiveness that it will give, where it is given in what we call the phase three trials. So that is the final stage.
MARTIN: Why do you think it's taken so long to find a vaccine for malaria? Malaria has been a scourge for decades, a generation - not to diminish the fight against HIV/AIDS, but HIV/AIDS is a relatively new phenomenon on the world health scene.
Dr. BINKA: Well, there are two major issues. First of all, you should remember that the vaccines we have today, most of them are against either viruses or bacteria. We actually haven't had a vaccine against a parasite like malaria. So this is a more complicated parasite than the ones that we've had solutions to. Number two, the amount of resources that have been channeled to really address this problem until recent years has been very piecemeal, and so we've not really made the progress that we expected.
The era of developing vaccines was very recent. It's not more than 20, 30 years ago when - that we started having breakthroughs. So there has been a push to control this disease, but I think the work on vaccines has not been too long and it initially was not being supported adequately. But in the last five or so years, this has changed.
MARTIN: What are the innovations that your research center has brought to this fight as you've created a massive database, you know, collecting information on patients and everything - the typical things that one would expect like their health status and indicators, but also their religion, marital status? Why do things like that matter?
Dr. BINKA: First of all, if you want to do a proper tryout and measure outcomes, you must be able to identify people. You must know their backgrounds, and you must know those who get the vaccine to be able to go back and measure whether they are protected or not. In our kind of setting, people really do not have the Social Security Number, say, you have in the United States. They don't have an address and a location, so it makes very difficult to do this appropriately.
So we have been putting together an effort to get this right, and the social context is also important in how you measure your outcomes. In this way, you also need to know the environment within it works, and part of the environment includes knowing the people a little bit more, knowing their social background and including religion and so on, as you mentioned earlier on. And all this will cultivate towards the holistic understanding of how well this can be delivered.
MARTIN: Now doctor, you've mentioned that there are strides being made in the effort to come up with a vaccine against malaria. But I do want to ask if your own, sort of, infrastructure there is sometimes an impediment, you know, sometimes your electrical supplies not as consistent, you know, lights going out. It has to slow down your work. I wondered if you'd ever consider moving the work to more of a high-tech center where those problems wouldn't exist.
Dr. BINKA: Yes, sometimes we've dreamt of that. But unfortunately, to be able to make sure that thing works, we have to test these vaccines in the populations in which it will be used. So that's why we have to work hard to overcome those challenges like electricity, water, trained personnel, laboratories, equipment, maintenance and so on.
Unfortunately, if we were to take this to where these conditions are ideal, this will not represent the real-life situations in which we're going to use these drugs.
MARTIN: Now you don't just stay in a lab all day, as I understand it. You're out and about with patients, yes?
Dr. BINKA: Yes, I am not a lab person. I'm a field epidemiologist, so I stay in the field most of the time looking at the conditions of patients, looking at how we can devise means of measuring the outcomes in a consistent and acceptable way, and training younger colleagues who are actually doing the work day to day.
MARTIN: Do you think, Dr. Binka, that we will see malaria eradicated in our lifetime?
Dr. BINKA: Definitely. I think so.
MARTIN: You do?
Dr. BINKA: Well, at this rate, we're getting there, slowly but in a much-improved way. With the new drugs and with the (unintelligible), in some areas, we are reducing the transmission very drastically. I think in the next 10 years, we will have a vaccine that is very effective and that will help us even to try to move faster than we are moving now.
MARTIN: Well, my goodness. What will you do then? Take up golf?
(Soundbite of laughter)
Dr. BINKA: No. Unfortunately, the work is not so simple. As a field epidemiologist, somehow, the frustration is that as you overcome one disease, others show up. That's really - there are others to be conquered. My colleagues are working on vaccines against venereal diseases. At the moment, some are working on several experiments in meningitis. And the issue of HIV is also unresolved.
So there are many more diseases that we have to tackle over time, but the most frustrating is that this particular disease malaria, with the knowledge that we have today should not actually be killing young children, but it does.
MARTIN: I guess I should let you get back to work then, huh?
Dr. BINKA: Thank you.
(Soundbite of laughter)
MARTIN: Okay. Dr. Fred Binka is executive director of In-Depth Research Centers. He spoke to us from Accara in Ghana.
Dr. Binka, thank you so much for speaking with us.
Dr. BINKA: Thank you for having me.
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