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TIPS ON MALARIA

  • HOW CAN MOSQUITOES BE CONTROLLED?

    Mosquitoes around the home can be reduced significantly by minimizing the amount of standing water available for mosquito breeding. Residents are urged to reduce standing water around the home in a variety of ways.

  • HOW CAN I PROTECT MYSELF FROM MOSQUITO-BORN DISEASES?

    The best way is to avoid being bitten by mosquitoes.This can be accomplished using personal protecting  while outdoors when mosquitoes are present. Treated bed nets should be used sleeping. Mosquito repellent should be used when outdoor.

  • WHO ARE AT RISK?


    Nearly half of the world’s population is at risk of getting malaria. Pregnant women are particularly at risk of malaria. Children under 5 years are at high risk of malaria.
     

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THE 'CRAZY' MALARIA VACCINE

One man endured the painful bites of over 2,000 mosquitoes, injecting malaria parasites into his bloodstream. They called him crazy. But, he is  bent on proving there is method in his madness. He wanted to be immune to malaria. Professor Steven Hoffman, CEO of American firm Sanaria Inc., is working tirelessly to develop whole-parasite malaria vaccines to eliminate the disease.  

He  is  aiming  at  high-level,  long-lasting  protection  against  plasmodium  falciparum,  the parasite responsible for most of the malaria-associated severe illnesses and death.

Sanaria has been awarded the 2014 Vaccine Industry Excellence (ViE)  award for the “Best Prophylactic Vaccine.” Prof. Stephen Hoffman was also among the 6 finalists for this year's ViE “Best Biotech CEO” award. In this interview with AMMREN correspondent Charity Binka, Prof Hoffman talks about his work.

AMMREN: What really motivated you to establish Sanaria?

A :  As   a  tropical  infectious  disease specialist, I  have focused  on  malaria because it is the most important tropical infectious  disease  in terms  of clinical cases  and deaths. After years of taking care of patients,  clinical  investigation, epidemiology,  and  immunology  of malaria,  I  began  to  focus on malaria vaccine development because I think a highly-effective vaccine would have the greatest  impact on preventing  malaria and  saving  lives. Whole  sporozoites administered by  mosquito  bites  have been known for many decades to induce extremely  high  levels of  protection against malaria.  However, one  cannot immunize  large numbers of people by having them bitten by infected mosqui- toes, and almost everyone in the  field thought  it  impossible  to  produce  a vaccine manufactured  in  mosquitoes. I established Sanaria, because I thought it was possible to make a whole-sporozoite vaccine and I believe  that such a vaccine can save millions of lives  and prevent hundreds of millions of cases of malaria.

AMMREN: What does Sanaria mean?
A:
Malaria comes from the Italian word, “mal aria”  which  means  “bad air.” Sanaria, “san aria” means “healthy air.”

AMMREN: Some scientists have described Sanaria malaria vaccine as a “crazy vaccine”. Is it really crazy?

A: In 2002 we published the work that was the  foundation for the  idea. The following year we published the idea. We were told by 99% of our colleagues that this was impossible and we were crazy. At this time Dr. Maurice Hilleman, the most accomplished vaccine developer of the second half of the 20th    century (from Merck) became the first member of our Advisory Board and was quoted in Nature as  saying we were “the  best  show  in town” (for malaria vaccine  development). A famous African medical scientist named  Fred  Binka also joined our Advisory  Board. Over the next few years we worked out how to manufacture the “crazy” vaccine. The team that figured out  how to  manufacture  the  “crazy” vaccine was led by Dr. B. Kim Lee Sim, my wife.

AMMREN: Take us through the processes.

A: In 2009 we submitted an Investiga- tional New Drug (IND) application to the FDA for PfSPZ vaccine and started  the first clinical trial. In 2010 we published a report  that  we could manufacture  the vaccine. In 2011 our colleagues led by teams at Naval Medical Research Center; National Institute of Allergy and Infectious Diseases (NIAID) and the National Institutes of Health (NIH);  University of Maryland Center for Vaccine Development and Sanaria reported the results of the first clinical trial of PfSPZ in Science magazine. The vaccine was extremely well tolerated  and  safe, but  not  very immunogenic or protective. However, with our colleagues at  the  Vaccine  Research Center (VRC),  NIAID and  NIH, we showed that the vaccine was potent, but had been administered by the wrong route and needed to be administered by directly injecting into the blood circulation. In 2013 our colleagues led by the  team  at VRC,  NIAID,  NIH and Sanaria reported in Science magazine that we had achieved  complete  protection  against malaria in six of six volunteers who received the highest dosage.

AMMREN: What  is the current stage of the vaccine?
A:
In 2014 six clinical trials in seven sites in the US, Mali, Tanzania, Equatorial Guinea and Germany are underway or will soon start. If this is crazy, why are so many distinguished clinical investigators, scientists, and institutions  in the  US, Africa  and Europe providing so much support for research and development of our vaccine?

AMMREN: How different is your vaccine from the RTS,S vaccine?
A:
  Quite different.  RTS,S  is  a  subunit, recombinant  protein  vaccine  that  only induces immune responses against one of the more than  5,000 proteins  in the  malaria parasite. PfSPZ Vaccine is a whole parasite, live vaccine that  could  potentially  induce immune  response  against  hundreds  or thousands  of  the  5,000  proteins in  the malaria parasite.

AMMREN: Where is your vaccine being tested? Are you  encountering any challenges carrying out such a trial in an African country?

A: PfSPZ  Vaccine is being tested now at two sites in the United States, and in Mali and Tanzania. Testing is planned to begin this year at a third site in the United States, and in Equatorial Guinea and Germany.

AMMREN:  GlaxoSmithKline  is said to have spent more than $300 million on developing the RTS,S vaccine which is still going on. In  the  face of current world financial crisis, do you think there is a future for such an expensive venture?

A: Developing a vaccine is very expensive. We need a malaria vaccine, and thus we must raise the funds to successfully do the job.

AMMREN:  Sanaria is said to  be  dedi- cated  to  using vaccines to  eradicate malaria.  Is  this  possible  in the  21s t Century?
A:
At Sanaria, we think so.

AMMREN: In a similar tone, GSK's Dr. Joe  Cohen, co-inventor  of  the  RTS,S vaccine says they are getting very close to getting a vaccine. Do you share in his optimism?

A: GSK and its collaborators have done an excellent job testing their vaccine. As far as I  understand  RTS,S/AS01  is intended to reduce the rate at which infants and young children develop the  clinical  disease  of malaria. Depending on the age group, the vaccine provides a 25% to 50% improvement  in the  time  until malaria is contracted.  The  international community, particularly African countries will have to determine how best to use this vaccine. In general they have not reported on preventing infection  in its entirety  and trying to stop transmission. Our effort is to develop  a vaccine that  has  high  level (80%)  protection  against infection  and therefore can be used in mass administration campaigns to halt transmission and eliminate malaria  from geographically- defined areas.

AMMREN: The world is anxiously  waiting for a malaria vaccine. How long do we have to wait?

A:  As stated  above it sounds like  there could be a licensed vaccine, RTS,S, in the coming year or two. We think it will take a minimum of 4 years for PfSPZ Vaccine to be licensed.
 

Editions: 
Twelfth Edition