On Tuesday, the GAVI Alliance—a public-private partnership largely funded by the Bill and Melinda Gates Foundation to develop a vaccine for malaria—announced encouraging results for a candidate vaccine.

A vaccine for malaria, which claims around 800,000 every year largely in India and Africa, is almost a holy grail of medical science. This is primarily due to the ability of malaria parasites to eventually grow resistant to vaccines. No candidate vaccine for malaria has ever made it beyond phase two trials and GAVI’s results from phase-three studies, therefore, look very promising.

A mosquito,the primary Malaria-causing vector in humans.(File photo Bloomberg)

Even if these vaccines were to ultimately prove as successful as say ones for small pox or rubella, beneficiaries of these vaccines can’t take lifetime malarial immunity for granted. Migration and poor sanitary conditions in developing countries such as India and several African nations can ensure that parasite genomes have even better access to a greater variety of potential genes. The latter could recombine and give rise to resistant mutants, overcoming the protective effects of RTS,S.

Unchecked antibiotic use, already at an alarming level, coupled with the ease of transportation, would make it harder than ever to find viable, long-lasting and affordable vaccines to diseases as intractable as malaria.

Public health experts have always advocated that a strong immunization programme, especially when it involves parasites as resilient as the malaria parasite, is incomplete without effective auxiliary measures such as sanitation and distributing insecticidal mosquito nets to those at risk. In implementing these, India has failed woefully. Even states like Kerala, with their high standards of public literacy and once-enviable primary healthcare centre system, have been frequently enervated by waves of mosquito-borne diseases such as leptospirosis—a result of deteriorating public health and sanitation system. Till these problems are fixed, the best of vaccines might do little to protect India’s children from recurrent, dangerous malaria.

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