Malaria causes 409,000 deaths per year, predominantly killing children in sub-Saharan Africa. The University of Oxford have created a vaccine proven to be 77% effective in early trials. The trials were on 450 children in Burkina Faso in Africa. This is the first vaccine to meet the WHOs target of 75% efficacy; previous vaccines have only reached 55% efficacy. This vaccine will now go through the ‘phase III’ clinical trial where it will be trialled in nearly 5,000 children between ages five months to three years across four African countries.
Why did this vaccine take so long, compared to the Covid-19 vaccine?
One reason it took longer for the malaria vaccine to be developed compared to the Covid-19 vaccines is that the coronavirus contains around a dozen genes, whilst malaria has thousands of genes. Using what you know about vaccine development, why would this affect the time taken to create it? Some people may argue that it is because Covid-19 crossed borders and led to deaths worldwide, it demanded more time, money, and resources to quickly develop a vaccine. Do you think this is fair? Why may this make people in sub-Saharan Africa feel like they are less of a priority or their lives aren't worth as much?
Ethical issues of trialling vaccines on children
As malaria is one of the leading causes of childhood mortality in Africa, it makes sense that the vaccine is being trialed on African children, as they need it most. However, it raises a question of ethics. According to UK law, anyone under the age of 18 is considered to be a child and only children who are Gillick competent can consent to any kind of treatment. If the child cannot consent, someone with parental responsibility can consent for them. Of course, in this case Gillick competence will not apply as the children in question are between three months and five years old. Do you think it's okay for a parent to consent for their child to be part of the vaccine trial when the child says they don't want to? What are some factors that should be taken into account when considering whether a child has the capacity to consent to their own treatment?
- A 15-year-old boy would like to be vaccinated without his parents' knowing. You need to assess his competence. What questions would you ask to see whether he is able to consent to the vaccine? Read up on Gillick competence to help you!
- If you were the leader of the World Health Organisation, how would you determine which diseases receive the most priority in terms of funding and resources? Consider both communicable disease (e.g. infectious diseases) and non-communicable diseases (e.g. diabetes, Parkinson's).