Lode Schuerman, director of global medical affairs,GlaxoSmithKline (GSK), Rixensart, Belgium, @GSK
Governments should prepare for implementing vaccine programmes next year: GSK and its partners have been working for three decades to develop a vaccine against malaria. This year, GSK intends to submit a regulatory application to the European Medicines Agency for RTS,S – our malaria vaccine candidate. If the required public health information, including safety and efficacy data from the phase III programme, is deemed satisfactory, WHO has indicated that a policy recommendation for the RTS,S malaria vaccine candidate is possible as early as 2015, paving the way for decisions by African nations regarding large-scale implementation of the vaccine through their national immunisation programmes.
The vaccine needs to be available for free: When it comes to enabling access to a malaria vaccine, we believe that no child should be deprived of a malaria vaccine because their parents can't afford it. If countries decide to implement the vaccine, it should reach those who need it most: children living in malaria endemic regions in Africa.
Two things need to happen so that cost will not be a barrier to access. First, in most African countries current childhood vaccines are provided to children for free. We hope that this would also apply for a malaria vaccine. Second, funding mechanisms exist today to ensure that childhood vaccines are made available to African communities, with limited financial contributions from the countries, thanks to Gavi support. We hope that similar mechanisms will be put in place for a malaria vaccine. Gavi has already indicated that there is a reasonable case to support the vaccine, provided it's approved by regulators, the WHO and individual countries.
Ashley Birkett, programme leader, Path's malaria vaccine initiative, Washington, DC, US @PATHtweets
Partnership is key for tackling this arduous task: Malaria, HIV and TB are considered three of the most difficult targets for vaccine development. Malaria vaccines also suffered from a lack of investment in product development since the risk of failure is high and the financial returns are low. This is why the PDP (product development partnership) model is so important; support of organisations like the Gates Foundation and engagement of partners like GSK is critical to our future success.
Rethink financing: The idea of funds being made available based on a future return on investment, such as a lower burden of disease and thus reduced healthcare costs, has been discussed, but this kind of mechanism is still very much in its infancy even in industrialised countries.
Wasif Ali Khan, scientist, International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh, @icddr_b
Don't forget about Asia: Although malaria incidence is still high in Africa, we can't ignore the malaria endemic regions in Asia. More than 70% of cases are asymptomatic and only possible to detect due to active surveillance. To move from control to elimination strategies even in low endemic areas where there is high asymptomatic cases, vaccine is the only option for malaria eradication along with other existing interventions
Barry Dyer, regional manager of medical information & analysis,International SOS, London, UK, @DrBazUK
Vaccines must be incorporated into a national campaign: Any candidate vaccine is going to have to be incorporated into the national immunisation campaign so that the target population can be appropriately followed up, especially for multi-dose regimens and booster doses. With many malaria endemic countries facing severe limitations in the number of health professionals, the communication of vaccine benefit to at-risk populations will no doubt rest on the shoulders of those already delivering vaccines against other infectious diseases. This is particularly true for those in more remote locations.
Mobile phones can spread the message: The prevalence of mobile phones in sub-Saharan Africa has already been used to good effect employing SMS to communicate the times and availability of vaccination stations in rural communities. I believe that GSK has partnered with Vodafone and others in previous programmes to boost vaccination uptake.
Stefan Kappe, principal investigator, Seattle BioMed, Seattle, US,@SeattleBioMed
We don't have the vaccine yet: I suggest that if we had a malaria vaccine that shows 90-100% protection, it would be introduced globally in countries that are endemic for malaria. Lets not forget that we do not have such a vaccine yet.
We can eradicate malaria, but we need investment: From a biomedical research perspective, it will be most important to find a malaria vaccine candidate that shows very high efficacy against malaria infection. This will prevent disease and death and also transmission. Such a vaccine is the most important tool to eradicate malaria. History has shown that infectious diseases can be brought to extinction with vaccines (for example smallpox). Investment in research and development of a malaria vaccine remains critically important.