Photo courtesy of Napo, Unsplash.
On Oct. 6, the World Health Organization (WHO) announced its recommendation of the RTS,S/AS01 malaria vaccine for both children and adults living in areas “with moderate to high P. falciparum malaria transmission.” This is a historic breakthrough against a disease that kills over 400,000 people each year. Over half of these deaths are African children under the age of five.
I was initially overjoyed by this good news, but the more I read about the vaccine, the more questions I had. The research behind RTS,S began in 1987, but the vaccine was not ready for approval by the European Medicines Agency until 2015. In its current form, it only prevents malaria between 30-40% of the time.
Why has it taken so long for a semi-effective vaccine to be developed for such a deadly disease? After all, the Pfizer-BioNTech vaccine for COVID-19 was approved by the FDA less than a year after the outbreak of the pandemic. What is the difference between these two research initiatives where one disease has had far more time to claim hundreds of thousands of victims?
The answer is funding. According to the Congressional Budget Office, “The federal government has provided more than $19 billion in assistance to seven private pharmaceutical manufacturers to develop and produce a vaccine or treatment for COVID-19.” Nearly six billion of this went to Moderna and NIAID, the developers of another COVID-19 vaccine approved by the FDA shortly after Pfizer-BioNTech’s.
In contrast, the RTS,S vaccine has received roughly $1 billion in total funding over 30 years of development, a significant portion of which came in the form of grant funds from the Bill & Melinda Gates Foundation. Let it be known that the source of this statistic is over two years old, and a more detailed funding breakdown could not be found. Now, the Malaria Vaccine Implementation Program (MVIP) lacks the resources required to make the RTS,S vaccine accessible to those in need.
Comparatively, the U.S. government spent roughly $12.64 billion on HIV vaccine research from 2000 to 2019. In the average year, this research received 3.5% of the budget that was given to COVID-19 vaccine research. Keep in mind, the CDC reported over 440,000 people died from AIDS from 1981 to 2000. How many lives could have been saved if more resources were dedicated to the HIV epidemic sooner?
Social inequality and global wealth disparity ensure issues that primarily affect developing countries and minorities do not receive the same resources given to problems experienced by more privileged groups. This is why it has taken eons for research in HIV and malaria to have breakthroughs compared to the swift timeline of the COVID-19 vaccines. These solutions are not shared equitably either, as demonstrated by how the poorest nations are not expected to receive COVID-19 vaccines until 2023.
Despite the appalling disparity in funding, economist and physician Jeffrey E. Harris claims the HIV research program “laid the groundwork” for breakthroughs in COVID-19 vaccine development. This proves that no amount of money dedicated to medicine is too small, especially when compared to the value of human life.
Now that “Operation Warp Speed” has proven what science can accomplish when properly resourced, I hope the federal government invests more in similar research and development initiatives and ensures the benefits are shared equitably. After all, if politicians cannot agree that their priority should be to improve the quality of life for as many people as possible, which includes access to advanced medical care, do they really deserve to be in office?
dbongiov@ramapo.edu
