Humans bite back
Meet the scientists who have broken boundaries to help develop a new malaria vaccine that could save millions of lives
Add Horizon: the Battle to Beat Malaria to your watchlist
It could prove transformational in humanity’s long battle against the mosquito. After a century of work, scientists in Britain – in collaboration with colleagues on four continents – have finally developed an effective vaccine against malaria. The tiny mosquito, and the malaria parasite it carries, is estimated to have killed as many as 50 billion humans over the course of our existence, and is still responsible for more than 600,000 deaths a year. The new vaccine could turn out to be one of the biggest improvements in global health since access to clean water. Horizon: the Battle to Beat Malaria, a riveting new BBC documentary, tracks the work of the Jenner Institute – an Oxford University department specialising in the development of innovative vaccines – as they reveal this amazing scientific breakthrough to the world. The Jenner’s director, Professor Adrian Hill, has been working to find a solution since the early 1990s – no fewer than 142 vaccines had previously been developed by other organisations, only to fall at the final hurdle.
Hill was working in the field when he was made aware that this new vaccine had enormous potential. “I was in Entebbe in Uganda, sleeping under a mosquito net as there’s a lot of malaria around, when I got an email from the guys in the lab to say the results of the tests we were running kept getting better and better. It became clear that it was different to everything we’d seen before. The results were undeniable.” Did he allow himself a moment of celebration after discovering that this vaccine – which has since been declared safe and effective by the World Health Organisation (WHO) – worked? “Not really, you just start thinking, ‘Could it be a false positive?’ So you repeat the trials again and again and hope to replicate the results.” Replicate them they did, and the vaccine – called R21 – began roll-out in 2023, with an initial 18 million doses delivered to the areas hardest hit by malaria, a disease that affects children worst of all – killing over half a million annually despite progress with bed nets, insecticides and drugs.
It was a long, hard road to get to this point. “We knew it wouldn’t be easy to develop a vaccine,” admits Hill. “We’ve had to break the boundaries of what was previously feasible because malaria is ingenious. It’s been around for at least 30 million years; we humans have only been here for one to two million. Covid had months to adapt to our immune system and did a reasonable job, but malaria has had tens of millions of years to work out how to exploit us.” Hill should know – his team played a vital role in the development of the AstraZeneca Covid vaccine.
Working on a malaria vaccine is my life’s mission
For Hill, a turning point in the battle with malaria came in the early 2000s from an unlikely source – celebrities. “It was a great time for global health,” he says. “There were pretty cool characters like Bono shining a light on the problems we were working on. They saw kids dying and asked people to donate – and it worked. Suddenly there was money for malaria research.” But they needed a lot of it. “Just the money that comes to Oxford University has been north of £100 million.”
Film-makers also captured the vital work of Dr Ally Olotu, a senior clinical research scientist who collected data and administered the vaccines on the ground in Tanzania, where he works at the Ifakara Health Institute. He has witnessed up-close the devastation the disease can inflict. “Living in rural areas where malaria most readily takes hold, you appreciate the enormity of the suffering. I have seen babies of just six months old riddled with it and requiring urgent blood transfusions.”
As a father of four young boys he feels it especially keenly. “It gets me emotional, seeing children in pain who are the same age as my own. Seeing what is happening in my community is very tough. Working on a vaccine is at the core of my being. I see it as my life’s mission.”
How does he feel now the vaccine, which attacks the parasite just after it enters the blood, is transforming lives? “Seeing the results for the first time was unbelievable”, he says. “I feel it most among the parents, they are really happy. Their children aren’t getting sick. I just hope the children of my country are able to receive it soon.” In a terrible twist of fate, Tanzania has yet to ratify it. “It’s immensely frustrating. All I can do is work with the government and hope they will listen sooner rather than later.”
The team isn’t resting on its laurels. Even now, “super mosquitoes” from Asia and the Arabian Peninsula have been found invading Africa, leading to spikes in cases. “It’s of concern,” admits Professor Hill. “Malaria has been around for so long because of how quickly it adapts.”
Despite the fights ahead, they must be proud of what they have achieved. After all, very few people work on something that will save lives for generations to come. “To contribute to something noble, I feel very privileged”, says Olotu. “To know I won’t just be helping my children but my children’s children is everything.”
“It’s been a good couple of years,” adds Hill, “but while we’re substantially impacting deaths in young children, there are other groups we need a vaccine for. Pregnant women, for example – if they contract the disease, it can result in stillbirths. The biggest goal is malaria’s elimination. We’re not there yet. There is still much work to be done.”
