The world's children. Malaria vaccine a sign of hope. Questions for the future.

Today, the New York Times and Washington Post reported success of an experimental vaccine for malaria. Every year, malaria sickens over 200 million people and kills about 780,000, mostly African children. Insecticide-coated bed nets and other remedies have helped, but this vaccine holds much  promise for wider protection against the deadly disease.

From the NYT-

The clinical trial is scheduled to continue through 2014 and will include tests on more than 15,000 children, from infancy on up. Early results released at a Seattle malaria conference on Tuesday showed that three doses protected 47 percent of the 6,000 children ages 5 months to 17 months from severe malaria. (The age group was chosen because newborns have some protection from their mothers’ antibodies.)

“The results are encouraging, but we still have a way to go,” said Dr. Tsiri Agbenyega, who heads malaria research at a Ghanaian hospital that was one of the 11 research sites. He announced the results, which are being published in The New England Journal of Medicine.

While 47 percent protection is not very effective — most vaccines are not released until they do better than 90 percent — the chief executive of Glaxo, Andrew Witty, noted that even that much protection would save millions of lives over a decade.

The vaccine has been in development for over 25 years, starting out for the American military but now mainly funded by the Bill and Melinda Gates Foundation. Known as RTS,S, it's manufactured by GlaxoSmithKline.

Glaxo has already spent more than $300 million on RTS,S, which will probably be named Mosquirix if it is introduced commercially, and expects to spend up to $100 million more, Mr. Witty (Glaxo CEO) said. Then, if the vaccine is approved, the company will make it at cost plus 5 percent for poor countries, with the 5 percent profit plowed back into malaria research.

Asked whether the Gates Foundation would pay for a vaccine that is less than 50 percent effective, Dr. Regina Rabinovich, the foundation’s chief of infectious diseases, said: “Would I prefer to see 100 percent efficacy? Obviously. But I look forward to the 2014 results, and any decision we make will be data-driven.”

Way back in 1948, The World Health Organization stated that- "Health is a state of complete physical, mental and social well-being, and not merely the absence of disease or infirmity." The efforts of many, including ones behind this new vaccine, have gone a long way to treat and cure diseases that affect or kill so many children in developing countries, in this case on the African continent. Over the years, millions of dollars and thousands of people have responded to heartbreaking emergencies and chronic conditions. Flew in food during times of famine, built clean-water wells, intervened in violent conflict, and assisted in establishing good government. 

Still, the words of WHO ring true. Achievements like this vaccine are important, but it's not an end in itself. It's a step. A piece of the puzzle. Hopefully it will have exponential, sustainable impact. But to be truly healthy, children throughout their growing years need more than vaccines. They also need nutritious food, safe homes, stable communities, effective and accessible schools, and paths to adulthood that prepare them to make a living and provide for their families and communities. Much progress has been made, but from a distance it seems like we aren't where we could be, especially knowing how wealthy the world is, even during this recession. There are so many institutions involved. So many people. 

Are they working closely enough together? Focused on cooperation, not competition? Is there too much redundancy? Too many layers and bureaucracy? Too many meetings, too many conferences, not enough coordinated, effective, on-the-ground action? Is technology being used to its potential for communicating needs AND solving problems? Are the nuances and machinations of politics holding back success? And if they are, what are the effective ways to combat them? Are local communities being mentored and educated to engage, take ownership, maintain efforts beyond the short term? Do observers in the developed world know and understand the complexities of issues in the developing world? Is the overall strategy moving swiftly away from dependency toward empowerment? Is the overall goal to sustain organizations OR sustain communities and the people, the children, who live in them?


I applaud successes like this vaccine and all efforts to improve the lives of children who live in deep poverty or areas of conflict. And it's easy for me to sit here and ask these questions. There are likely some reassuring answers. At least I hope so. I also hope organizations, especially some of the new, agile, lean ones offer ways for people like me who care about the world's children to get more involved. More than making a donation. Maybe asking these questions is another way to contribute. Provoke a new kind of dialogue. In this interconnected, interdependent, fast-changing world, it's time we all have skin in the game. Knowing that the destiny of the world's children affects everyone.

A footnote---I wish Bill and Melinda Gates would focus their abundant wealth and big hearts on efforts like this vaccine, and back off from involving themselves so much in our nation's public school system. While data-driven decisions are integral to developing effective vaccines, heavyweight obsession with data in the classroom can do more harm than good in the long run. Teaching is much, much more than test preparation. We can easily lose the forest for the trees. For it's the most human endeavor on the planet, whether between parent and child or teacher and student. It can't be measured exclusively in data points. And it weighs on me that the Gates could take their data-driven education ideas into developing countries if they decide to expand their influence into all the world's schools.