NANORO, Burkina Faso — No hospital in this rural community has recorded a COVID-19 death. But another menace fills graves on a grimly predictable schedule.
The seasonal downpours that soak the red dirt roads here nurture clouds of mosquitoes that spread malaria. Researchers call it a forgotten epidemic: The parasitic disease kills more than 400,000 people each year. Most victims are children in Africa.
The coronavirus pandemic, by contrast, has claimed about 130,000 lives on the continent in the past 15 months, according to World Health Organization estimates. Yet only the coronavirus has commanded a surge of global resources that fast-tracked vaccines, smashing development records and reshaping attitudes toward what is pharmaceutically possible.
Now scientists in Burkina Faso aim to harness that momentum to end what they see as the region’s more urgent threat.
“We are all frustrated in Africa to see how COVID gets so much attention compared to malaria,” said epidemiologist Halidou Tinto, regional director of Burkina Faso’s Institute of Research in Health Sciences. “If malaria concerned the West, the attention would be much more focused.”
Tinto, 52, is leading clinical tests on the most promising injection against malaria yet — a shot found to be 77% effective for a group of Nanoro children over a 12-month trial, researchers reported this year in a study published in the Lancet.
The vaccine candidate, known as R21, is the first of its kind to cross the WHO’s 75% threshold, raising hopes and a pressing question: If Pfizer and Moderna can speed up dose deployment, why is this effort taking so long?
“Every second we delay the introduction of this vaccine, we lose more kids,” Tinto said at his office in Nanoro, where scientists nearby studied blood samples under microscopes, collecting the data required to move forward.
Work on R21, developed by Oxford University’s Jenner Institute, began in the United Kingdom more than a decade ago.
Now researchers are striving to secure prequalification from the WHO — a distinction that attracts funding and logistical support from global donors, and the first step for virtually every vaccine used in Africa. Regulatory approval from countries normally follows.
In the absence of a vaccine, other preventive measures have dominated the fight.
Malaria cases worldwide have fallen with the rise of rapid diagnosis, bed nets and better drugs: Global mortality dropped by 60% from 2000 to 2019, according to the WHO. Deaths in Africa decreased by nearly a half over that period. But progress since then has ground to a near halt.
Tinto and his colleagues say a vaccine is the missing piece.
Before the pandemic rush, the mumps inoculation held the record for fastest lab-to-authorization time: Four years, achieved in the late ‘60s.
The coronavirus shots completed in months were aided by extensive research already conducted on similar viruses, as well as advances in manufacturing. But it was enormous sums of money that got them over the finish line.
The United States alone poured more than $9 billion into coronavirus vaccine development. The world spent $7.3 billion into malaria-related research and development from 2007 to 2018, according to the WHO.
Researchers blame the disparity on market forces: The countries most devastated by malaria tend to be the poorest.
“You’re not going to get malaria in England anymore, or the U.S., so richer countries, which have the research budgets to tackle these tropical diseases, have to spend the right amount of money to make an impact,” said Adrian Hill, director of the Jenner Institute. “It does seem odd that malaria, at least for Africa, is not considered an equivalent priority when there’s this huge number of children dying every year.”