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World’s first malaria vaccine can save thousands of children lives
One of the world's deadliest diseases, malaria takes the life of a child every two minutes.
- Malaria, one of the world's deadliest diseases, kills 435,000 people a year, most of them children in Sub-Saharan Africa.
- Three African countries are set to receive the world's first malaria vaccine this week as part of a WHO pilot program.
- The vaccine has the potential to save the lives of hundreds of thousands of children worldwide.
The 20th century has seen some truly profound advances in human medicine. We now produce clean water and uncontaminated food at unprecedented levels. We've eradicated smallpox and rinderpest — the former having been one of history's deadliest diseases, the latter having caused widespread, depopulating famine — and we're close to eradicating deadly, debilitating diseases such as polio, yaws, and rabies.
But some medical leaps have been more elusive. One of the most devastating has been our inability to find a cure for malaria.
Malaria is among the world's deadliest diseases. It kills 435,000 people worldwide every year, the vast majority in Sub-Saharan Africa. Ninety percent of all malaria-related deaths occur in Africa, and children under the age of five are its most likely victims. In fact, every tenth child death in 2016 was the result of malaria.
But that tragic paradigm may be changing soon. The World Health Organization has launched a pilot program for the world's first malaria vaccine, a change that's been three decades in the making.
Countering the malaria epidemic
Image source: CDC / Wikimedia Commons
The malaria vaccine pilot program will launch in Malawi this week. In 2016, the country suffered 45 malaria-related deaths per 100,000 people. In the coming weeks, Ghana and Kenya will introduce the vaccine as well. In 2016, these countries suffered 69 and 11 deaths per 100,000 respectively.
The vaccine, called RTS,S, will be administered in a regimen of four doses. The first three will be given to children between five and nine months of age. The final dose will be provided around the children's second birthday. The program aims to vaccinate around 360,000 children per year across the three countries. It will focus on areas with moderate-to-high malaria transmission rates in the hopes of maximizing the impact.
"Malaria is a constant threat in the African communities where this vaccine will be given. The poorest children suffer the most and are at highest risk of death," Dr Matshidiso Moeti, WHO Regional Director for Africa, said in a statement. "We know the power of vaccines to prevent killer diseases and reach children, including those who may not have immediate access to the doctors, nurses and health facilities they need to save them when severe illness comes."
WHO's press statement notes that the pilot program is a global partnership. It has brought together a range of in-country and international partners to coordinate with the ministries of health in the three pilot countries. GSK, the vaccine's developer and manufacturer, will donate 10 million doses.
"This is a day to celebrate as we begin to learn more about what this tool can do to change the trajectory of malaria through childhood vaccination," Moeti added.
Difficulties in eradicating malaria
However, the vaccine is not a silver bullet aimed at ending the malaria epidemic. RTS,S does not have a 100 percent success rate, offering only partial protection. In clinical trials, it prevented approximately 4 in 10 malaria cases (3 in 10 for life-threatening malaria).
As such, WHO is presenting the vaccine as a "complementary malaria control tool." The vaccine paired and supported by other preventative measures, including bed nets, indoor insecticides, and antimalarial treatments.
"It's a difficult disease to deal with. The tools we have are modestly effective but drugs and insecticides wear out — after 10, 20 years mosquitoes become resistant. There's a real concern that in 2020s, [cases] are going to jump back up again," said Adrian Hill, a professor of human genetics and director of the Jenner Institute at the University of Oxford, told CNN.
Malaria has proven difficult to eradicate because of its nature. The disease is caused by a parasite of the genus Plasmodium. Its life cycle is split between a sexual stage in its mosquito hosts and an asexual stage in human hosts. When a mosquito bites an infected human, it contracts the disease from that person's red blood cells.
When it bites another person, the mosquito transmits the disease to a new host. The infected patient develops a fever, chills, headaches, and other flu-like symptoms. If untreated, it can develop into severe malaria, where the symptoms can manifest into anemia, organ failure, and neurological abnormalities. Any mosquito that bites this person has the chance to then pass on the disease further.
The difficulty in preventing mosquito bites, the insect's growing resistance to insecticides, and changes the parasite undergoes during its life cycle, all contribute the difficulties on controlling and containing malaria in the world's poorest countries.
Developing sustainable change
Graph showing the percentage of global malaria deaths per world region. Africa accounts for 90 percent of deaths resulting from the disease. (Source: Our World in Data)
WHO's Sustainable Development Goals are 17 directives comprising 169 targets. The ultimate aim is to advance peace and prosperity for all people.
The program's third directive is to ensure health and well-being for all people of all ages. Among its targets are the end of the AIDS, tuberculosis, and malaria epidemics by 2030 and the reduction of mortality for children under 5 to as few as 25 per 1,000 live births worldwide.
Despite the difficulties still ahead, any substantial reduction in malaria deaths is a welcome change and a significant step in achieving this goal.
Thanks to this vaccine, hundreds of thousands of children will likely avoid a crippling, painful death. Communities in some of the world's poorest regions will be given a chance to better stabilize and grow. And the pilot may help scientist develop better strategies for future endeavors.
The vaccine's development came at an auspicious moment, too. Malaria cases began to rise in 2017, after nearly two decades of decline.
"The malaria vaccine is an exciting innovation that complements the global health community's efforts to end the malaria epidemic," Lelio Marmora, executive director of Unitaid, said. "It is also a shining example of the kind of inter-agency coordination that we need. We look forward to learning how the vaccine can be integrated for greatest impact into our work."
Northwell Health is using insights from website traffic to forecast COVID-19 hospitalizations two weeks in the future.
- The machine-learning algorithm works by analyzing the online behavior of visitors to the Northwell Health website and comparing that data to future COVID-19 hospitalizations.
- The tool, which uses anonymized data, has so far predicted hospitalizations with an accuracy rate of 80 percent.
- Machine-learning tools are helping health-care professionals worldwide better constrain and treat COVID-19.
The value of forecasting<img type="lazy-image" data-runner-src="https://assets.rebelmouse.io/eyJhbGciOiJIUzI1NiIsInR5cCI6IkpXVCJ9.eyJpbWFnZSI6Imh0dHBzOi8vYXNzZXRzLnJibC5tcy8yNTA0Njk2OC9vcmlnaW4uanBnIiwiZXhwaXJlc19hdCI6MTYyMzM2NDQzOH0.rid9regiDaKczCCKBsu7wrHkNQ64Vz_XcOEZIzAhzgM/img.jpg?width=980" id="2bb93" class="rm-shortcode" data-rm-shortcode-id="31345afbdf2bd408fd3e9f31520c445a" data-rm-shortcode-name="rebelmouse-image" data-width="1546" data-height="1056" />
Northwell emergency departments use the dashboard to monitor in real time.
Credit: Northwell Health<p>One unique benefit of forecasting COVID-19 hospitalizations is that it allows health systems to better prepare, manage and allocate resources. For example, if the tool forecasted a surge in COVID-19 hospitalizations in two weeks, Northwell Health could begin:</p><ul><li>Making space for an influx of patients</li><li>Moving personal protective equipment to where it's most needed</li><li>Strategically allocating staff during the predicted surge</li><li>Increasing the number of tests offered to asymptomatic patients</li></ul><p>The health-care field is increasingly using machine learning. It's already helping doctors develop <a href="https://care.diabetesjournals.org/content/early/2020/06/09/dc19-1870" target="_blank">personalized care plans for diabetes patients</a>, improving cancer screening techniques, and enabling mental health professionals to better predict which patients are at <a href="https://healthitanalytics.com/news/ehr-data-fuels-accurate-predictive-analytics-for-suicide-risk" target="_blank" rel="noopener noreferrer">elevated risk of suicide</a>, to name a few applications.</p><p>Health systems around the world have already begun exploring how <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7315944/" target="_blank" rel="noopener noreferrer">machine learning can help battle the pandemic</a>, including better COVID-19 screening, diagnosis, contact tracing, and drug and vaccine development.</p><p>Cruzen said these kinds of tools represent a shift in how health systems can tackle a wide variety of problems.</p><p>"Health care has always used the past to predict the future, but not in this mathematical way," Cruzen said. "I think [Northwell Health's new predictive tool] really is a great first example of how we should be attacking a lot of things as we go forward."</p>
Making machine-learning tools openly accessible<p>Northwell Health has made its predictive tool <a href="https://github.com/northwell-health/covid-web-data-predictor" target="_blank">available for free</a> to any health system that wishes to utilize it.</p><p>"COVID is everybody's problem, and I think developing tools that can be used to help others is sort of why people go into health care," Dr. Cruzen said. "It was really consistent with our mission."</p><p>Open collaboration is something the world's governments and health systems should be striving for during the pandemic, said Michael Dowling, Northwell Health's president and CEO.</p><p>"Whenever you develop anything and somebody else gets it, they improve it and they continue to make it better," Dowling said. "As a country, we lack data. I believe very, very strongly that we should have been and should be now working with other countries, including China, including the European Union, including England and others to figure out how to develop a health surveillance system so you can anticipate way in advance when these things are going to occur."</p><p>In all, Northwell Health has treated more than 112,000 COVID patients. During the pandemic, Dowling said he's seen an outpouring of goodwill, collaboration, and sacrifice from the community and the tens of thousands of staff who work across Northwell.</p><p>"COVID has changed our perspective on everything—and not just those of us in health care, because it has disrupted everybody's life," Dowling said. "It has demonstrated the value of community, how we help one another."</p>
"You dream about these kinds of moments when you're a kid," said lead paleontologist David Schmidt.
- The triceratops skull was first discovered in 2019, but was excavated over the summer of 2020.
- It was discovered in the South Dakota Badlands, an area where the Triceratops roamed some 66 million years ago.
- Studying dinosaurs helps scientists better understand the evolution of all life on Earth.
Credit: David Schmidt / Westminster College<p style="margin-left: 20px;">"We had to be really careful," Schmidt told St. Louis Public Radio. "We couldn't disturb anything at all, because at that point, it was under law enforcement investigation. They were telling us, 'Don't even make footprints,' and I was thinking, 'How are we supposed to do that?'"</p><p>Another difficulty was the mammoth size of the skull: about 7 feet long and more than 3,000 pounds. (For context, the largest triceratops skull ever unearthed was about <a href="https://www.tandfonline.com/doi/abs/10.1080/02724634.2010.483632" target="_blank">8.2 feet long</a>.) The skull of Schmidt's dinosaur was likely a <em>Triceratops prorsus, </em>one of two species of triceratops that roamed what's now North America about 66 million years ago.</p>
Credit: David Schmidt / Westminster College<p>The triceratops was an herbivore, but it was also a favorite meal of the T<em>yrannosaurus rex</em>. That probably explains why the Dakotas contain many scattered triceratops bone fragments, and, less commonly, complete bones and skulls. In summer 2019, for example, a separate team on a dig in North Dakota made <a href="https://www.nytimes.com/2019/07/26/science/triceratops-skull-65-million-years-old.html" target="_blank">headlines</a> after unearthing a complete triceratops skull that measured five feet in length.</p><p>Michael Kjelland, a biology professor who participated in that excavation, said digging up the dinosaur was like completing a "multi-piece, 3-D jigsaw puzzle" that required "engineering that rivaled SpaceX," he jokingly told the <a href="https://www.nytimes.com/2019/07/26/science/triceratops-skull-65-million-years-old.html" target="_blank">New York Times</a>.</p>
Morrison Formation in Colorado
James St. John via Flickr
|Credit: Nobu Tamura/Wikimedia Commons|
Archaeologists discover a cave painting of a wild pig that is now the world's oldest dated work of representational art.
- Archaeologists find a cave painting of a wild pig that is at least 45,500 years old.
- The painting is the earliest known work of representational art.
- The discovery was made in a remote valley on the Indonesian island of Sulawesi.
Oldest Cave Art Found in Sulawesi<span style="display:block;position:relative;padding-top:56.25%;" class="rm-shortcode" data-rm-shortcode-id="a9734e306f0914bfdcbe79a1e317a7f0"><iframe type="lazy-iframe" data-runner-src="https://www.youtube.com/embed/b-wAYtBxn7E?rel=0" width="100%" height="auto" frameborder="0" scrolling="no" style="position:absolute;top:0;left:0;width:100%;height:100%;"></iframe></span>
The Persian polymath and philosopher of the Islamic Golden Age teaches us about self-awareness.