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At long last, can malaria be eradicated?

Two new vaccines may finally turn back the ancient plague of malaria. But the arrival of the vaccines also complicates the path to ending the disease

Capture
It’s beautiful but Kenya’s Wigwa River is a breeding site for mosquitoes (Photograph by Kang-Chun Cheng)

APOORVA MANDAVILLI
| New York Times

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NEW YORK, USA - All through childhood, Miriam Abdullah was shuttled in and out of hospitals, her thin body wracked with fever and ravaged by malaria.

She was so sick so often that her constant treatments drained her parents, who also cared for her many siblings, both financially and emotionally.

“At some point, even my mum gave up,” recalled Ms. Abdullah, now 35.

In Nyalenda, the poor community in Kisumu, Kenya, where Ms. Abdullah lives, malaria is endemic and ubiquitous.

Some of her friends developed meningitis after becoming infected; one died. “Malaria has really tormented us as a country,” she said.

There are tens of millions of horror stories like Ms. Abdullah’s, handed down from generation to generation.

But now change is in the air: Malaria is the rare global health scourge about which experts are sanguine — so much so that some have begun to talk about eradicating the disease.

“I think there’s so much room for optimism,” said Philip Welkhoff, director for malaria programs at the Bill and Melinda Gates Foundation.

“Later this decade, we could actually launch a push that gets us all the way to zero.”

China and El Salvador were certified malaria-free last year, and the six countries in the Greater Mekong region, including Vietnam and Thailand, have driven down cases by about 90%. About 25 countries are expected to have eliminated malaria by 2025.

The bulk of infections now occur in Africa. Even there, despite the limitations imposed by the coronavirus pandemic, nearly 12 million more African children received preventive malaria drugs in 2020 than in 2019.

But it is the arrival of two new vaccines that portend a sea change.

The first, called Mosquirix, was 35 years in the making. It was approved by the World Health Organisation just last year and may be distributed as soon as late next year.

A more powerful malaria vaccine, developed by the Oxford team that created the AstraZeneca Covid vaccine, may be just a year or two away.

Many experts believe it is this formulation, which has shown an efficacy of up to 80% in clinical trials, that may transform the fight against malaria.

Still more options are on the horizon, including an mRNA vaccine being developed by the German company BioNTech.

There are also monoclonal antibodies that can prevent malaria for six months or longer, bed nets coated with long-lasting insecticides that paralyse mosquitoe and new ways to trap and kill mosquitoes.

“It’s an exciting time,” said Dr. Rose Jalang’o, who led a pilot test of the Mosquirix vaccine in Kenya, where it was given to children alongside other immunisations.

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