They are from RTS, S, the malaria campaign vaccine in Malawi. How and over what period of time has this been developed?
Schuerman: 1986 has started the vaccination team in Belgium. The breakthrough came in the form of an 1997-published study in which six out of seven volunteers were protected by the malaria vaccine. Subsequently, clinical trials in Africa and 2015 finally followed the licensing of the vaccine
What has to happen until a research breakthrough becomes an approved vaccine?
Schuerman: 1997 we tested only on seven volunteers. Then we went to Africa in the malarial regions and vaccinated first adults and then children. You have to be very careful, and it takes years before you can finally include newborns. The vaccine was changed slightly again, and further studies had to be made with the final version. Ten years ago, we had enough data to run a so-called Phase Three study in eleven locations in seven African countries. It turned out that four out of ten malaria cases can be prevented by the vaccine.
30 years of research, 40 percent chance of success, about one billion euros investment: What makes the fight against malaria so complicated?
Schuerman: Malaria is not a virus or bacterium, but a parasite. And malaria parasites change several times: the mosquito-injected parasite remains in circulation for only about 30 minutes. Afterwards it hides intracellularly in the liver. When he comes out of the liver and begins to infect the red blood cells, he is already a completely different parasite than the previous one. And there is even a third form that reinfects mosquitoes. That's why it's so complicated to develop a malaria vaccine. When talking to immunologists or vaccinologists, they complain that the vaccine only works to 40 percent. They are used to vaccines such as those for measles, which are almost one hundred percent effective. But if you talk to malaria experts, then they are enthusiastic. Because they do not know tools that are more effective than those 40 percent. So a vaccine is a very important step forward. The people in the affected countries also see it that way. Malaria is so well known that mothers queue for this vaccine. And this vaccine also serves as an opportunity to improve the coverage of other vaccines. In addition, we are working to further improve the efficiency of the malaria vaccine.
Tuberculosis calls for more deaths than malaria, more than one million a year worldwide. Now GSK has also taken up this fight.
Schuerman: To date, tuberculosis vaccines have not been very successful and that could change soon. We are in Phase Two of the development of a tuberculosis vaccine: We performed a trial with 3.000 volunteers in South Africa, Zambia and Kenya. And showed that the vaccine is able to reduce the number of cases by half. This really is a breakthrough, no vaccine has done that yet.
The pharmaceutical industry does not enjoy the best reputation everywhere. How does GSK agree on the profit interests of a company and its social mission?
Schuerman: Of course, we need to find a way to make the vaccines financially viable for the company, but in principle I prefer to calculate the return on our Global Health projects in terms of public health impact rather than financial returns. And these effects are huge: with our vaccines, we prevent the death of a child every three to four minutes.
Many thanks for the interview!