The applicants have previously collaborated successfully on malaria vaccine development, and have characterised a field site area prioritised by Ghana Health Services. This project builds on these strengths, and will focus on research and capacity building underpinning the development of new malaria vaccines targeting the asexual blood-stage P. falciparum parasites that cause all the clinical symptoms of the most severe type of malaria in humans. In four Ph.D. study programs we will conduct laboratory and pre-clinical research on highly promising vaccine candidate antigens. Specifically, we will study PfEMP1 variants implicated in the pathogenesis of the most life-threatening malaria complications. In addition we will study two parasite antigens (PfRh5 and PfRON2), necessary for parasite invasion of erythrocytes, and known to be targets of immune responses that can interrupt parasite multiplication. The Ph.D. students will have access to clinically very carefully characterized malaria patients in an area where the intensity of transmission is sufficient to make the studies proposed feasible. Furthermore, all the Ph.D. programs will benefit from renowned international collaborating experts, and be closely supervised thanks to an integrated institutional exchange program for senior scientists. We are confident that this will ensure both cutting-edge collaborative malaria vaccine development research and genuine and sustainable capacity building.
Project completion report:
The type of malaria that dominates in Africa is also the most serious type of the disease. It continues to cost almost half a million lives a year there, mainly among young children. Progress over the last decade to curb the disease is increasingly under threat from growing parasite resistance to the drugs used to prevent and treat the infection, and by similar resistance problems with the chemicals used to deter and kill the insects transmitting the disease.
An efficacious vaccine would be a decisive game changer, but such a vaccine remains an elusive goal. This is partly due to the complex biology of the disease, but also to a lack of qualified scientists working in the affected countries.
The goal of the MAVARECA project has been to alleviate this deficit by training Ghanaian scientists to the level of PhD through an intensive research collaboration aimed at identifying novel vaccine-based interventions against this devastating disease.
We have reached this goal by training of scientists, by building new research capacity, and by publishing a substantial number of scientific papers reporting important new knowledge gained from our collaborative research.
The presence of a basic research project in a resource-constrained clinical setting has the potential to result in immediate improvements in health care beyond the direct study objectives. This can happen when the research project staff and the clinical staff take a mutual interest in each other’s work. In the case of the MAVARECA study, clinical project work at Hohoe Municipal Hospital was conducted in close collaboration between project nurses and clinicians and the routine hospital staff. In order to run the project, it was necessary to implement a number of operational changes and to update clinical management algorithms to the level of the national recommended standards of care. The hospital leadership immediately realized the potential to implement these improvements in the general running of the hospital. Examples of this included a better organization of rapid diagnostic testing for malaria and better adherence to treatment recommendations. It also motivated the hospital general laboratory to a faster and more complete blood testing, and to an improved supply of key pharmaceuticals. The resulting improvements were presented and discussed at the one-week International course on pediatric infectious diseases and Global Health, which was held in Ghana in January 2016. The course included a full day at Hohoe Municipal Hospital, open for all local staff members, in addition to the course participants. At follow-up visits in Hohoe, we have noticed that most of these improvements have been sustained beyond the duration of the project.