By Chukwuma Muanya
• Lagos, others employ multi-pronged strategy to combat disease • Scientists genetically modify human embryos for first time • Controversial technique could lead to designer babies
MEDICAL experts have hailed a malaria vaccine that will prevent millions of young children from catching the disease, which could be available in October after trial results found that it reduces number of cases by half.
Researchers say the vaccine, which has just completed the final stages of testing, could make a ‘substantial contribution’ to controlling the disease.
Drug firm, GlaxoSmithKline has applied for a licence from the European Medicines Agency (EMA) for the RTS,S vaccine. The news is significant because RTS,S is the first malaria vaccine to reach advanced trials.
Tests were carried out on 15,500 toddlers and babies in sub-Saharan Africa. According to the study published in The Lancet journal, among those who had three doses of RTS,S and a booster shot, the number of clinical cases of malaria – those confirmed by a doctor – was reduced by 36 per cent after four years.
But the protection waned over time, boosters worked less well than the initial dose and the vaccine was not as effective in younger children. Scientists have worked on the vaccine for more than 20 years – at a cost of more than £330 million, but experts say there is a long way to go.
There is no licensed vaccine against malaria anywhere in the world and researchers say they are hopeful the results will be sufficient for RTS,S to gain a licence from the EMA.
The World Health Organisation could then recommend its use by October this year. In the trials, an average of 1,363 cases of clinical malaria were prevented over four years for every 1,000 children vaccinated, and 1,774 cases in those who also received a booster. Over three years, an average 558 cases were averted for every 1,000 infants vaccinated, and 983 cases in those also given a booster dose. Meanwhile, the National Coordinator, National Malaria Elimination Programme (NMEP), Dr. Nnenna Ezeigwe, and the Lagos State Commissioner for Health, Dr. Jide Idris, have hailed the breakthrough in malaria vaccine.
They, however, said the country and the state is utilising a multi-pronged strategy; which include vector control interventions, preventive therapies, diagnostic testing, treatment with quality-assured Artemisinin-based Combination Therapies (ACTs), and strong malaria surveillance to control and eliminate malaria.
Ezeigwe said: “Development of medicines goes through several complex procedures and technologies, which most developing countries are still trying to perfect.
The Federal Ministry of Health is encouraging the development of even traditional medicine and if any product shows any promise I am sure it will receive adequate support. Prevention is actually cheaper and better.”
Idris, during a community sensitisation campaign to commemorate this year’s World Malaria Day at the Amu Market in Mushin Local Council Area said that various integrated preventive measures that have been put in place by the State government is geared towards combating malaria.
Highlighting the various integrated preventive measures, the Commissioner explained that Long Lasting Insecticide Nets (LLINs) have been deployed to communities, stressing that nets are also distributed in public health facilities to children who had completed their immunisation schedule and also to pregnant women who booked for antenatal care, adding also that pregnant women are freely and routinely given in the prescribed manner Sulphadoxine Pyrimethamine (SP) for Intermittent Preventive Treatment of malaria during Ante Natal Clinics.
Meanwhile, Chinese scientists have admitted to changing the genes of human embryos for the first time. The announcement confirms rumours that some researchers have been conducting ethically questionable genetic experiments.
Some scientists have already reacted with horror at the idea, for fear it could be misused to allow parents to ‘select’ the genes they will pass on to their grandchildren.
Researchers at Sun Yat-sen University in Guangzho have yesterday published their research in the journal Protein & Cell, according to a report in Nature. In the paper, researchers led by Junjiu Huang, attempted to downplay concerns by using ‘non-viable’ embryos, which can’t develop into babies.
The team tried to tweak the gene responsible for β-thalassaemia, a potentially deadly blood disorder, using a germ line editing technique known as CRISPR/Cas9. CRISPR technology precisely changes target parts of genetic code.
Unlike other gene-silencing tools, the CRISPR system targets the genome’s source material and permanently turns off genes at the DNA level. The team studied the ability of the CRISPR/Cas9 system to edit the gene called HBB responsible for β-thalassaemia However, others argue that the technology could also be used to rid families of devastating inherited diseases like cystic fibrosis or certain cancers.
The team tried to tweak the gene responsible for β-thalassaemia, a potentially deadly blood disorder, using a germ line editing technique known as CRISPR/Cas9. But the researchers involved said that their results revealed ‘serious obstacles’ in using the technique on human embryos.
CRISPR technology precisely changes target parts of genetic code. Unlike other gene-silencing tools, the CRISPR system targets the genome’s source material and permanently turns off genes at the DNA level.
The DNA cut – known as a double strand break – closely mimics the kinds of mutations that occur naturally, for instance after chronic sun exposure.
But unlike UV rays that can result in genetic alterations, the CRISPR system causes a mutation at a precise location in the genome. When cellular machinery repairs the DNA break, it removes a small snip of DNA. In this way, researchers can precisely turn off specific genes in the genome.
Human DNA – Deoxyribonucleic acid (DNA) is a molecule that encodes the genetic instructions used in the development and functioning of all known living organisms and many viruses. Huang’s group studied the ability of the CRISPR/Cas9 system to edit the gene called HBB. The team injected 86 embryos and then waited two days for the CRISPR technique to work.
Nature reports that of the 71 embryos that survived, 54 were genetically tested. The tests found that 28 were successfully spliced, but only a few contained the replacement genetic material. “If you want to do it in normal embryos, you need to be close to 100 per cent,” Huang told Nature.
“That’s why we stopped. We still think it’s too immature.” Until now scientists have concentrated on using genome editing techniques on somatic cells – non-reproductive cells like those found in skin, muscle, nerves, bone and liver for example – to help them study diseases.
Modifying the DNA of human embryos so that DNA changes are preserved in the germ line – the sperm and eggs – means such alterations can be passed on to future generations. Improvements in genetics are causing designer babies to near ‘100 per cent efficiency’ in trials using mice, a leading scientist has warned.
Dr. Tony Perry, a geneticist at the University of Bath, said that society needed to be prepared for the day parents can choose certain traits in their children. The warning follows a breakthrough last April in which scientists were able to cure a genetic liver disease in living, adult mice using the CRISPR-Cas9 gene editing technique. The CRISPR technology precisely changes target parts of genetic code and could be used to create designer babies. Idris said:
“Another preventive strategy being deployed in the State is the Indoor Residual Spraying (IRS) which is the application of long-acting chemical insecticides on the walls and roofs of houses for the effect of curtailing malaria transmission. The 6th round in the series of IRS activities was implemented in seven LGAs namely Ojo, Ikorodu, Badagry, Amuwo-Odofin, Kosofe, Epe and Ibeju-Lekki LGAs in 2014 and approximately 650,000 rooms were sprayed.”
The Commissioner who was represented at the event by the Deputy Director in charge of Disease Control in the State Ministry of Health, Dr. Rotimi Agbolagorite, added that the State Ministry of Health has also implemented Larviciding; which is the application of larvicides to bodies of water to attack mosquito larvae and prevent the development of the larvae to adult mosquitoes in Ikosi-Isheri and Agboyi Ketu local council development areas both within the Kosofe Local Government Area.
Idris stated that the State government has also made available in all public health facilities in the State, Malaria case management which entails the compulsory diagnosis of malaria either by the use of the Rapid Diagnostic Test kits or microscopy and effective treatment with the use of Artemisinin Combination Therapies (ACTs) antimalarials, adding that all patients can access the service at no cost.
The Commissioner said: “It is important that the citizens in the state are equipped with the right information to enable them take appropriate actions regarding malaria control.
To this end, information dissemination is carried out through jingles on the radio, community sensitisation and mobilisations activities where information leaflets and fliers are distributed to the citizens.”
He posited that the fight against malaria is a collaborative one amongst all relevant stakeholders that requires the commitment of everyone, stressing that all residents must all be active in ensuring that their environment is clean and free of any collection of water that can serve as a breeding site for mosquitoes.
Idris said: “Everyone should sleep inside a Long Lasting Insecticide net every night. Pregnant women should receive Sulphadoxine Pyrimethamine (SP) for Intermittent Preventive Treatment of malaria during ANC clinics.
You should also visit the nearest health facility when ill and demand for laboratory testing prior to the administration of antimalarial.” The Commissioner noted that despite the huge investments in malaria control and the significant impact in the decline in malaria morbidity and mortality, an estimated 198 million cases of malaria occurred globally in 2013 and 584,000 associated deaths were recorded, stressing that the statistics were according to the year 2014 World malaria Report.
He stated that tragically, most cases occurred in Africa while most deaths affects children under five years of age, adding that the cosmopolitan nature of Lagos and the abundant distribution of coastal areas encourage the availability of stagnant water resulting in breeding sites for the anopheles mosquito.
Also, while speaking at the event, the Executive Secretary of Mushin Local Government Area, Hon. Babajide Bello noted that keeping a healthy environment devoid of breeding sites for mosquitoes is one of the ways Malaria scourge can be fought.
He charged residents of local government as well as market men and women of Amu Market to cue into various preventive interventions being put in place by the State government in fighting malaria. April 25th is World Malaria Day, a day set aside by the Roll Back Malaria (RBM) partnership to draw attention to the burden of malaria.
The theme for this year’s commemoration is “Invest in the future: defeat malaria” and aims to draw significant attention to the additional efforts required in achieving the targets of the Millennium Development Goals in 2015.
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