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Global Developments in the Fight Against Malaria

Fight Against Malaria
According to the World Health Organization (WHO) in 2019, malaria infections stood at almost 230 million globally. Of these malaria incidents, 409,000 cases led to fatalities. These are the striking and often overlooked numbers encasing the global fight against malaria. Malaria, a parasitic infection that mosquito varieties ruthlessly spread, is an ancient disease plaguing regions across the globe, particularly within the warmer climates of the tropical and subtropical areas of the world.

The cyclical nature of the disease from uninfected mosquitoes to infected hosts then infected mosquitoes to uninfected hosts, is in part the reason this disease is difficult to counteract outside of preventive measures, such as traditional nets, drugs and various forms of insecticides. However, these methods have limitations. The insidious nature of repeat infections adds insult to injury, with reports indicating up to six malaria infections annually among some children. Now, the dawn of a malaria vaccine hopes to make strides in the fight against malaria.

The Dawn of a Malaria Vaccine

The daunting reality and statistics on malaria illustrate only one side of the story on emerging aid over the last three decades. After years of research and trials by the manufacturer, on October 6, 2021, WHO officially authorized the widespread use of a malaria vaccine that GlaxoSmithKline created called Mosquirix. This is not only a win in the fight against malaria. Mosquirix is “also the first vaccine ever recommended for use by WHO to combat a parasitic disease in humans.”

Dr. Pedro Alonso, director of WHO’s global malaria program, says in a press release that “[i]t’s a huge jump from the science perspective to have a first-generation vaccine against a human parasite.” The vaccine, which targets children, has the potential to prevent “23,000 deaths in children younger than 5 each year.” As it stands, the vaccine manufacturer has “committed to producing 15 million doses of Mosquirix annually” until 2028.

Development in Tandem With the Global Health Order

This trend toward vaccination campaigns, development and authorization does not of course appear in a vacuum. After decades of stalling efforts on malaria prevention, a new global health order has ushered in a recent admiration for the efficacy of vaccine funding, research and implementation on the back of the global struggle against COVID-19. Organizations championing the global vaccine battle against COVID-19, such as GAVI, the Vaccine Alliance, “likely play a crucial role in negotiating the financing, procurement and delivery of” the Mosquirix vaccine.

Other major players in the fight against COVID-19 are also entering the ring. BioNTech recently launched a malaria project in July 2021. Its intentions are the use of mRNA technology, which has proven highly effective in COVID-19 vaccines, in the fight against the malaria parasite. Clinical trials of the world’s “first mRNA-based vaccine for malaria prevention” will begin at the close of 2022. These new multilateral and multi-agency relationships in health care, which the pandemic brought about, could be the stepping stones for future breakthroughs in global health.

Looking Ahead

Spurred on by new movements in global health, the malaria vaccine will make strides within infant and youth populations across at-risk regions like Africa and beyond. Mosquirix pilot programs in Kenya, Malawi and Ghana “found that the vaccine is safe. There is community demand for it and it is a cost-effective prevention method.” While perhaps not intrinsically linked to the new global health order, the world is making strides in combating an ancient and sometimes overlooked disease through emerging technologies, monetary funding and intellectual endorsements. It is safe to say that the new malaria vaccine could set new precedents as to the way the world cooperates on matters of global health security so that the international community can develop long-lasting strategies to keep at-risk regions safe, productive and healthy.

– Aidan Swayne
Photo: Flickr

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The COVID-19 Vaccination in Hungary

The covid-19 vaccination in HungaryThe coronavirus infection rate is dropping rapidly throughout Hungary thanks to a steadily increasing rate of COVID-19 vaccination. From a peak of around 10,000 daily new cases in March 2021, as of June Hungary sees fewer than 200 daily new cases.

In May, Hungarian prime minister Viktor Orban’s chief of staff Gergely Gulyas announced that Hungary will not join the new vaccination deal. As part of the deal, Pfizer and BioNTech will provide an additional 2.6 billion doses throughout the European Union (EU). Hungary is the only EU country that has opted out of the deal.

According to Gulyas, the Hungarian government is confident in its current supply. Gulyas stated that in the event a booster becomes necessary, “there are plenty of vaccines from Eastern and Western sources as well.”  Orban used his strong ties with Russia and China to purchase and deploy vaccines from those countries even before the EU approved them.

Vaccination Campaign Successes

Since January, almost half of Hungarians have received their second dose of the COVID-19 vaccine. As a result, infection rates have declined rapidly across the country. Compared to the rest of the EU, Hungary had a relatively low infection rate throughout the pandemic.  Hungary peaked at about 10,000 new cases per day. In the first week of July, there was an average of 41 new infections reported per day. That’s less than one percent of the daily average during the country’s peak on March 25. Furthermore, the country has seen fewer than one million COVID-19 cases overall.

Hungary has also expanded vaccine eligibility quickly. It is the first EU country to approve vaccination for citizens as young as 16, who are eligible to receive the Pfizer/BioNTech doses. Around 90,000 young people have already registered for the shot, accompanied by parental permission for those under 18. Euronews reported that “according to government plans, by mid-June, all Hungarians willing to get a Western-developed jab can be vaccinated.” Hungary is hoping to be able to vaccinate children as young as age six which would mean virtually all schoolchildren by early fall when school starts.

Low-Income Families and Vaccination

The percentage of Hungarians at risk of poverty has declined steadily in recent years, dropping around 3% from 2013 to 2020.  Hungary’s at-risk poverty rate was 12.3 % in 2020.  COVID-19 has been harsher on the at-risk population, especially the Roma population living in poor settlements.  The Hungarian Civil Liberties Union (HCLU), a human rights non-governmental organization (NGO) advocates for targeted measures to protect the Roma from COVID.  HCLU claims that the Hungarian government has overlooked the fact that the Roma have been more vulnerable to COVID’s economic consequences because they lack any financial reserves and rely on day-to-day odd jobs.

A Promising Start

With half of Hungarians vaccinated and many more eligible, working life is returning to normal, allowing the economy to thrive. As low-income citizens including the Roma get vaccinated, they will be able to return to work without fear of illness. Also, fewer people will lose their jobs due to business closures. This successful COVID-19 vaccination campaign is leading Hungary toward a safe return to life as it used to be. Furthermore, the government is confident that its current supply of vaccine doses can sustain the campaign’s success.

– Riley Prillwitz
Photo: Unsplash

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COVAX Donates Vaccines to Southeast Asia

Vaccines to Southeast Asia
Southeast Asia sits as an outlier in its success as a region in managing the pandemic. In fact, countries like Vietnam, Laos, Cambodia and Thailand were better prepared to deal with the pandemic than most. Without hesitation, countries in the area utilized their experience and resources to manage the outbreaks in a fashion that prevented high economic costs. Nonetheless, after recent spikes and a lack of access to vaccines, a worry is growing in policymakers across the region that inoculating the populations will be difficult to accomplish. COVAX is a WHO initiative that provides significant assistance in this struggle as it has promised millions of vaccinations to countries across the region. COVAX donated millions of vaccines to Southeast Asia to assist in its inoculation outreach.

Southeast Asia and COVID-19

Aside from a few outliers including Malaysia, Indonesia and the Philippines, much of Southeast Asia has fared well managing the pandemic. For example, Brunei, Vietnam, Timor Liste, Laos and Singapore all have total COVID-19 related deaths under 100. Similarly, both Cambodia and Thailand are under 1,000 COVID-19 related deaths. Almost all of these countries boast populations in the millions, with Vietnam alone having nearly 100 million people.

In sharp contrast, the wealthier developed nations in Northeast Asia fared far worse than the underdeveloped neighbors to the south. Japan has recorded 11,940 deaths and over 650,000 cases. Less stark, South Korea has recorded nearly 2,000 deaths and over 134,000 cases. 

Essentially, Southeast Asian nations achieved this through a decisive response to the initial outbreak and a culture that made universal mask-wearing (95% of Thais and 94% of Vietnamese wear masks in public) and precautions palatable. The efficiency in response emerged from experience in dealing with previous outbreaks including SARS, bird flu and dengue fever. As cases began to rise in China and worry about the virus grew, countries across the region sprang into action. Southeast Asian countries initiated lockdowns, border closures, contact tracing and widespread testing. Many instituted public service campaigns to promote safety precautions, including mask-wearing and social distancing. 

Success 

Vietnam illustrates this point well. Despite sharing a border with the epicenter of China, it has been a rare success story. After dealing with the SARS and the bird flu in 2000, it increased its medical infrastructure investment by 9% a year. As a result, when news about COVID-19 began to come out of Wuhan, Vietnam acted decisively. The country increased its screening procedures and extended the Lunar holiday to keep families at home. Vietnam also chose localized lockdowns as clusters developed, opposed to nationwide lockdowns that impose high economic costs. The national government also had a thorough testing and a contact tracing regime that slowed down the spread through proactive quarantining.

Vaccination

Nevertheless, the resources and experience that lend themselves to managing the pandemic with efficiency are not necessarily applicable to inoculating the population. Southeast Asia does not have an established pharmaceutical industry that can develop a homegrown vaccine. As a region filled with low- to middle-income countries, purchasing the vaccines necessary to inoculate the entire population is difficult. Without a vaccinated population, states remain vulnerable to COVID-19 spikes.

As a result, the vaccination rates are low in most Southeast Asian nations. As of May 17, 2021, none of the states in the region have vaccinated more than 10% of their population, except for Singapore, which vaccinated 23% of its population. Cambodia is the second-largest vaccinated population at 7% while Brunei is the least vaccinated at 0.2%. All other Southeast Asian states fall within the two rates.

The lack of vaccinations has become acutely problematic as Southeast Asia is bracing for a new wave of infections that threatens to become unmanageable. Cambodia’s daily rate shot up to nearly 500 a day. In the last three weeks, Laos has seen daily cases rise tenfold. Even in Vietnam, the poster child of managing the pandemic, “community transmissions began climbing sharply [as] workers have been told to prepare for 30,000 patients.” As Southeast Asia deals with the new surge, vaccinating its population becomes critical.

COVAX

Nevertheless, to make up for this shortfall, WHO has donated millions of vaccines to Southeast Asia through COVAX. It began on March 2, 2021, when Cambodia received 300,000 vaccines. On April 23, 2021, Malaysia received 268,000 doses, and WHO aims to provide Malaysia 6 million in total. On May 8, Indonesia received 1.3 million AstraZeneca COVAX procured vaccines and is supposed to receive 6 million by the end of May. The Philippines received 2 million AstraZeneca vaccines and 193,000 Pfizer vaccines. Meanwhile, in late March, Vietnam welcomed 811,000 AstraZeneca vaccines in its first batch of vaccines from the COVAX fund.

As the world looks to turn the corner towards a post-pandemic world, vaccinating lower to middle-income countries similar to those in Southeast Asia is a necessary and critical step. Work must occur to inoculate the region to levels to allow a post-pandemic world to manifest. For example, BioNTech announced that it would develop a new manufacturing space. External powers including the Quad, China and Russia promise millions more in vaccine donations and further COVAX procured donations. Yet, WHO took a critical first step when COVAX donated millions of vaccines to Southeast Asia.

– Vincenzo Caporale
Photo: Wikipedia Commons

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COVID-19 Vaccinations in Hong Kong

Hong Kong Vaccinations
At the moment, hundreds of thousands of people around the world are receiving vaccinations against COVID-19. However, there are still many who have not received doses. Governments are working to supply enough vaccines in order to return the world to the previous level of production. However, many roadblocks exist that places must overcome before that can happen, and such difficulties are not always easy to solve. A problem that has arisen in Hong Kong is that many individuals are reluctant to take the vaccinations offered to them.

Distrust in Hong Kong

As of March 2021, a month after the beginning of the distribution of vaccines, only 6.01% of Hong Kong’s population had been vaccinated. However, Hong Kong does not have a shortage of vaccines. Although the country received the batches of doses it ordered, the vaccination centers have run low on personnel, and many people have not been signing up to receive the vaccines. There is distrust between the government and the citizens of Hong Kong, which makes it difficult for many individuals to come to terms with the idea of utilizing government-issued medicine. While there are both Western and Eastern produced vaccines available to the public, many people are wary of receiving them. Media coverage reports of fatalities due to vaccines have deterred many individuals despite government medical consultants claiming the deaths were from causes unrelated to the vaccine.

Vaccine Recall

For a period of time, Hong Kong put the vaccinations on hold due to the discovery of some faulty packaging. There were concerns that someone had tampered with the product, and distributions underwent recall for inspection. After a 12-day suspension, BioNTech determined the vaccine was usable, and the vaccination processes resumed. However, Hong Kong received an additional 300,000 doses on the chance that any vaccines required replacing. There is hope that with the arrival of new supplies, people may be more willing to trust that the vaccines will have no fatal effects.

Incentives

Due to the public reluctance toward vaccinations in Hong Kong, the government has reached the conclusion that incentives may be necessary. For example, exemptions from travel bans or issued vaccination certificates that could grant entry to special locations may entice more people to obtain vaccinations. With the potential to relax social distancing restrictions, the government hopes to have the number of vaccinations reach at least 70% of the population. Especially for individuals who are not natives of Hong Kong, such as students and those on work visas, higher vaccination rates may allow people to return home once countries loosen travel restrictions.

The government is also pushing to have businesses vaccinate employees in a bid to show that employee health improves with the vaccine. This process has mostly occurred in air flight companies, which will allow aircrew employees to avoid the mandated quarantine whenever they land within the country. The offer would then extend to other citizens as well.

– Seren Dere
Photo: Flickr

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How mRNA Vaccines Could Help the World’s Poor

mRNA VaccinesVaccinations have been one of the most successful disease prevention tools the world has ever seen to date; the rise of vaccinations and a decrease in disease mortality go hand in hand. The World Health Organization is cited stating that vaccinations prevent about six million deaths worldwide every year. That number could increase if a new type of vaccine, an mRNA vaccine, proves effective.

Some of the more impoverished nations of the world encounter a variety of setbacks when trying to implement vaccinations on a wide scale. Some populations simply cannot afford vaccines while others living in rural areas may not have access or transportation to reach a medical facility. Further, others still may live in unsanitary environments that allow pathogens to easily thrive and spread throughout their communities. Fortunately, scientists in Germany have been testing mRNA vaccines that could have the possibility of eliminating some of these issues.

Testing mRNA Vaccines

Last year, the Bill & Melinda Gates Foundation partnered with CureVac and BioNTech (two biotechnology corporations) to experiment with new ways to make vaccines. These new vaccines utilize the body’s naturally administered mRNA, which are the molecules that turn genetic information into proteins. In 2018, the companies found positive results while testing these vaccines on both small and large animals.

Later that year, mRNA vaccines designed to combat rabies began phase I of their testing on human participants. The testing took place in Germany and involved 130 participants who had not yet received a rabies vaccine in their lifetime. Then the results of the mRNA vaccine were compared with the results of another treatment.

“The first study participant enrolled in this rabies clinical trial is a significant milestone for CureVac, and allows the company to demonstrate its ability to trigger an immune response in vaccine naïve populations, which is different from vaccines just boosting an already existing immune response such as a flu vaccination,” explained Dan Menichella, CureVac’s CEO.

Implications of mRNA Vaccines

Though the study is not expected to be fully completed until 2021, researchers are finding that mRNA vaccines may be potentially more durable than standard versions of preventative vaccines.

If that is proven to be the case, the implications of how these new vaccines could help the world’s poor are huge. The mRNA vaccines would be able to be developed quickly—quickly enough, it is speculated, to respond to grave infectious disease outbreaks like Ebola. They would also be considerably cheaper to manufacture. And while most vaccination plants cannot be renovated or repurposed to produce other vaccines, only one mRNA vaccine plant could create multiple vaccines that target different diseases.

While mRNA vaccines still have a long way to go in the way of human testing and production, they seem to be off to a good start. It may one day completely revolutionize the way developing countries—or any country, for that matter—vaccinate. And although the medical field is a complicated one, one thing is for certain: CureVac and BioNTech are companies everyone should keep their eyes on for future breakthroughs.

– Haley Hiday
Photo: Flickr