The Big Three Vaccine: Facts, Figures and Possibilities

HIV, Tuberculosis and Malaria are known as the ‘Big Three’ infectious diseases, reports by the WHO shows that the ‘trio’ killed more than 2.8 million people in 2020.

HIV/AIDS is still a global health crisis, especially in Africa, the first case was reported over 40 years ago. Africa makes up about 15.2% of the world’s population, yet more than two-thirds of total HIV infections in the world, approximately 35 million people are from the continent. The high volume of infections on the continent is largely caused by poor access to healthcare, unsafe sexual practices, and high mother-to-child transmission. Each year 8 million contract tuberculosis and between 300 million and 500 million fall ill from malaria. These infectious diseases are treatable and preventable, however, despite the gains achieved over the years, millions of people continue to die from HIV, TB and malaria.

The Covid19 pandemic opened a world of possibilities on the myriads of ways mRNA technology can be harnessed to fight some of the world’s health concerns. The Covid19 mRNA vaccine has generated a lot of attention as a result of its application prospects and advantages, which include short development cycle, easy industrialization, simple production process, flexibility to respond to new variants, and the capacity to induce better immune response.

mRNA are messenger ribonucleic acids that elicit an immune response from cells before breaking down. They function by creating a sequence that is coded for a disease-specific antigen – a substance that causes the body to make antibodies against it; once this antigen is produced within the body, the immune system can recognise it and get ready to fight the real virus or bacteria.

 According to a 2018 review, US-based scientists said those mRNA vaccines represented a promising alternative to conventional vaccine approaches because of their high potency, capacity for rapid development and potential for low-cost manufacture and safe administration.

“The mRNA vaccine field is developing extremely rapidly; a large body of preclinical data has accumulated over the past several years, and multiple human clinical trials have been initiated,” the scientists said. The data suggest that mRNA vaccines have the potential to solve many of the challenges in vaccine development for both infectious diseases and cancer.”

In March, the United States National Institute of Allergy and Infectious Diseases (NIAID) announced the launch of phase I clinical trial evaluating three experimental HIV vaccines based on an mRNA platform. NIAID Director Anthony Fauci said that while finding an HIV vaccine had proven “a daunting scientific challenge”, there was now “an exciting opportunity to learn whether mRNA technology can achieve similar results against HIV infection.”

Dagna Laufer, Vice president of clinical trial development at the International AIDS Vaccine Initiative (IAVI) further said “The HIV virus is a much more complex target for mRNAs.  If shown to have an acceptable safety profile and able to induce the desired immune response, the vaccine candidates could be the first stage of a multi-step vaccine regimen,” she says.

“But we will need to undertake multiple trials to achieve this goal, and these trials will be conducted over at least a five- to ten-year period.”

Researchers are pushing to leverage the success of mRNA technology against COVID-19 by exploring how it could be effective against tuberculosis, the world’s second most deadly infectious disease. “The mRNA technology has progressed over the years and actually leap-frogged during the COVID-19 pandemic. It is the right time now to use mRNA technology for developing a new and effective vaccine for TB” says Suvanand Sahu, Deputy executive director, Stop TB Partnership

Bacillus Calmette–Guérin (BCG) is the only licenced TB vaccine and it is a century old. It is an ‘attenuated vaccine’ – a weakened version of the disease-causing organism is used – that protects young children, however, the protection it provides for adults and adolescents is inconsistent.

There is a need for increased funding and political commitment to support the research and development required to create an effective mRNA TB vaccine. In July 2021, the German biotechnology company BioNTech announced that clinical trials of its mRNA vaccine for TB, developed with the Bill & Melinda Gates Foundation, will start in 2022. In October 2021, reports by the Tuberculosis Vaccine Initiatives pipeline tracker show that over a dozen candidate vaccines were undergoing clinical trials, including five in phase III trials.

According to scientists, a malaria vaccine tested on children in West Africa has shown the efficacy of around 77 per cent, hailing it as a breakthrough in the fight against the disease. The R21/Matrix-M vaccine is the first malaria vaccine to reach the 75 per cent efficacy target set by the WHO. It was developed by the Clinical Research Unit of Nanoro (CRUN), Burkina Faso and their partners at the University of Oxford in the UK.

The subjects in the study reported no serious side effects from the vaccine, which was found to be safe and can be manufactured at low cost on a large scale. Researchers are optimistic that by testing the vaccine in different contexts on a larger number of children, its efficacy will be confirmed and the vaccine can be considered for registration.

Minister of Health for Burkina Faso, Charlemagne Ouedraogo, said the findings offer hope for the elimination of malaria in the country and across the continent.

“We believe that the solution against malaria will come from Burkina. We encourage the team to continue the third phase to give us results that will allow us to go further so that a vaccine is put on the market that will allow us to reduce morbidity and mortality from malaria,” he said.

This story was produced under Dataphyte’s 2022 Media Fellowship.

Torinmo Salau

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