jolissa jamal, cuz so she said the likes of amnesty international, of urge the premier li not so allow this to happen. well, for the funds for this of course, is a, as a big moment, what value it will be a real change in the clubs of for she's going forward me brocker in new castle. thank you very much for that neeve. ah, no. again, i'm fully back to bo, with the headlines on al jazeera, an earthquake in pakistan's belushi sand provinces scale. at least 20 people is struck in the early hours of thursday flattening houses. while most people wear asleep, come on, hider has more from the hardest hit area. we are in our nie a more district in baluchistan, situated about 5 hour drive from the city of winder, which is the provincial capital. the alternative that saying that did it damage or to 500? how did at least 20 people have been killed. the military had to you delegate this

to evacuate. the most seriously injured, most of the injured of gods include women and children. the idea had received a number of off their truck. dozens of trunks in eastern saddam have been allowed through a blockade set up by protesters that's been causing a supply crisis to demonstrate is let the trucks carrying medicine to pass for humanitarian reasons. members of the beach or chide, a force or saddam to close angry over the regions economy and a peace deal between the government and rebel groups. pfizer says it submitted a request to the main us drunk regulator for emergency approval of it's covered 19 vaccine for children from 5 to 11 trials for the age group began in july, the nobel prize for literature has been awarded to times of the board novelist abdur resign corner, his work focuses on colonialism and the fate of refugees is the 1st time a black african has won the prize in 2 decades. the u. n. human rights council has

voted to and it's war crimes investigation in yemen. of the 47 member, you and council 21 countries voted against the resolution to extend the investigation by 2 years with 18 in favor. independent investigators have said in the past that all sides in yemen, ongoing conflicts have committed acts that may amount to or crimes. iran sworn minister is in be rude for talks on lebanon spiraling economic crisis a month after the formation of a new government. jose, i'm here abdulla he, unmet lebanese president. michelle. our to ron is an important backer of hesper law, which is one of the main groups in lebanon's government and former civil servant, while made gravel. he has been appointed as a new prime minister in guinea. he will coordinate the transition back to democratic rule following last months. cool. those are the head mice mix. it's inside story. stay with us. ah.

while the world focused on vaccines against covert breakthrough has been made in fighting another disease? the w h r has approved a malaria jack. so can i help? why thought one of the biggest killers of children in africa? and will it be affordable for those who need it the most. this is inside story. ah. hello and welcome to inside story on come out santa maria. it kills more than $400000.00 people a year out of an estimated $229000000.00 cases. and now there's

a vaccine for it. and for once we are not talking about code 19, it is in fact a malaria vaccine. and the world health organization is recommending it go into wide spread use among children in africa. now obviously there is a lot of optimism about this, but as we'll discuss shortly, there is still a lot of work left to do, most notably funding and the political will to make that happen. well, introduce you to our panel in a moment. first, the support from victoria cation b. it's being described as a game changer for child health, a vaccine that could help save the lives of hundreds of thousands of children each year in sub saharan africa. monica has been with us for millennia. and the dream of my letter boxing has been a long held but unattainable dream to day. the r t s. s. money vaccine. more than 30 years in the making changes the course of public health history. the vaccine smith klein vaccine has been given to

infants and gonna kenya i'm allowing since 2019 as part of a pilot program, it was found to be about 30 percent effective. it preventing severe cases of the disease which is transmitted through mosquitoes. but that figure raised around 70 percent when the vaccine was combined with all the treatments. i think eradication is still a quite some time of it. but i think the combination of benefits, kimura prophylaxis and dyslexia and another way see maybe other like seats in the future. will bring a malaria burden of disease down substantially and africa. malaria causes fever, vomiting, and fatigue, and kills more than full $100000.00 people each year. mostly children on to 5 as well as pregnant women. the r t s. s. vaccine, also known as most garrick's has been welcomed by researches as an historic breakthrough. but many on the continent worry about funding and whether

a mass roll out will be possible in the wake of cov, 19, and other competing priorities. we've grown my are being a disease boss, especially i by and large i and disease for some south african, a children. ah. and given the digital geez, that's our countries are facing our which will that be international? we're g r e is going to, i stand out and, and make dyslexia available at to with children needed. the world health organization recommends giving the vaccine to babies in 3 phases, followed by a beast to shoot. but that may take time. the next step is to the global vaccine alliance known as gabby, to look at whether the vaccine is a worthwhile investment. if it's approved, gabby will buy it for countries that request it process that it's expected to take at least a year, victoria gate and be al jazeera. ah. so let's bring

in our guests and do we have a doctor in the house? yeah, we've got 3 of them in fact, all in africa as well. first of all, in a virgin nigeria, aka color, who's the regional advisor for tropical and vector born diseases at the world health organization, african region. in johannesburg, south africa, helen race, a board member at kathy, which you heard about in that report, the global alliance, vaccines, and immunization and in nairobi, kenya of dallas, alba and epidemiologist, and research scientist at the african population and health research center. doctors. welcome to you all. i feel we are in very good hands to day dr. parker. let me start with you in a boucher 39 percent of malaria cases prevented by this vaccine. and it goes up to 70 percent when it's combined with the anti malaria drugs. are you good with that? 39 percent. it doesn't say, i mean in fact, i think the w at joe says it needs an efficacy, right? a 50 percent, at least for approval. so are these numbers?

all right, we believed that every life saved from malaria is what the investment i think my braces when combined with lamar, they are called boxes, going up to 70 percent. is i so total, we realize that my linear control depends on a ma moment. it to kid that is full of imperfect dogs. and this was what we are advancing as technology delivers more tools will keep improving. so welcome the approval to scale up r g a says vox them of africa because that live that is sued is a life what city certainly is stuck to helen reese. let me get your initial thoughts as well on those numbers. again, just explaining to have used the combination of the vaccine and the anti malaria drugs. i do those numbers stack up to you, they acceptable. well,

they certainly do. one of the reasons is that to we need more tools to tackle malaria. you've heard the figures and in the african region a we, we estimate that we're losing about $260000.00 children every year from, from this. but more than that is repeated attacks that often occur in childhood. really affects childhood development as well. so it's not just the death that we definitely want to reduce in severe diseases, hospitalization, and has the chronic effect as well. so just bear in mind that if we combine a 70 percent reduction in severe disease is huge, it's, it's, it's a massive step forward because we kind of plateaued with all the tools that we've got in terms of being able to now reduce malarial case numbers. so we needed more tables and this is one of them. okay, so let's build on the idea of that. plateauing with dr. bellas alba in nairobi downs is there has been a, a plateauing of that. and also i would note this 6 years,

i think it is of tests and trials that have been going on on this vaccine and, and actually years before that, as well as part of the whole development. is that normal to be taking that long? i sometimes wonder if my covert brain thinks that things should be happening a lot faster now because of what we've been talking about in the last 18 months. yeah, thank you. i think i unknown you to a lot of people are who are not close to maria programming and research and not aware that her discharge for many of oxen has been regina for the last 30 years. lake ebay, w 2, executive director mission. so the 60, as you are alluding to is out of something better. now vaccine development has been a customer tool. right now we still don't have any charities, roxanne, and their attempts are still being met. so it's not sri or an expected or, and had of but we are happy that her with good and something at will, can consider to be relatively effective when combined with other existing

interventions. it can you say what has proved so elusive in these 30 years? i know with these a long term projects, obviously, but has there been something which has been constantly, you know, proving to be a hurdle? yet the most did the maria, causing organism that is, the plasmodium is a very tricky organism as a proposal that has a different stages, it can hide in different parts of the body, the blood and it has a vector phase. so as opposed to other organisms like versus that into your body and there are, there can be tracked it probably in one area. this on this protozoa has been or is actually very, i will see that this is causing jam and our we talk about her antagonistic variable, meaning that her, if your target to 7 and again, our property is in

a few years time that want to be effective or that won't work. so the problem has been around how do we target the antigens do those. and again, that can be used to induce in unity and therefore fight a disease. when one is exposed, transaction caving dr. parker color in a booty. let me come back to you. tell me about the trials, the places where it's happened, ah, the number of people involved. there was even some controversy as well. the british medical journal was saying last year that they said that the deb joad the w h. i was only using implied consent, it wasn't actually getting explicit consent from parents for these trials. how's it all gone? well, the 1st in a lot of love did by latino do boxes in, in gala, in kenya and in malawi was i looked at the national immunization system. the piloting was not to try out the say, try us. i've been quite

a bit bid and buxton group issues. what's the difference? what would apply the 100 and a trial then? yes, the piloting was to look at this ability of using existing routine english, a mechanism to deliver the investing and looking at the impact of it was negative on the system. and the result is that the vaccines can be delivered, immunization stemming countries, and it has no negative impact in the system. my dad did disrupt any existing delivery of boxes. so i haven't proven that i learned that the bus news, if it shows a bit and made up of this advisory group approved the white us go use all these boxes. and that's why we're excited that it can be delivered through do still not the another article system, not it. can it routine immunizations. and we find out the box in is so, you know, it's a brand on his own because people know my lydia is deliberately affect the development

of the children gods. and therefore, we found that people on their own go for the box without much investment in, in massive communication that is outside the reduced system. so we are excited about some become available countries will, i don't get boxes and they live i, to those to children. and see the children not just from those who saw by hopefully from the chronic impact of my list of malaria on development of the children on stunting on, on, on the electron performance in schools. right. so you talk about it being picked up and moving forward and actually getting to the paper. and that's why i'm really glad we've got helen raced with us today. who's on the board of kathy, the vaccine alliance from what i've been reading today, it now comes to gabby. ah, which has to decide, and i think it's december, they're expecting to decide about whether this is viable, whether this can be picked up and moved forward. is there any question that it

won't be it? well, i don't want to preem to board discussion. well, what i certainly can share with you is that the garvey board has been this won't be the 1st on the coffee board would have discussed. the millerio vaccine has been following the development of the vaccine very, very closely at garvey as an alliance is the aim of garvey, is to support the world's least well resourced countries in purchasing vaccines and strengthen the health systems to deliver vaccines. and in helping countries have all of the bells and whistles that are required to deliver vaccines. call it. so gabby has had a huge impact and save millions of millions of lives as an alliance through that kind of support to the, the delivery of many, many different particularly childhood vaccines. so this kind of thing, which is looking at a disease which has really got stuck but is affecting so many children in some of the poorest countries of the world. and is the kind of thing that garvey would

certainly want to prioritize. but obviously in doing that, we'll be talking with the donors who support garvey, to say, how much money have we got? is there a window? can we can this am garvey also depends on w chose recommendations. so yesterday's announcement by dump a chose is a very important milestone in the sort of process towards garvey decision making. but as i say, something like this would certainly fall into a theoretically, would fall into a garvey portfolio. am because their aim is to save lives and particularly in the poorest countries at the risk of oversimplifying. and you did allude to it though, it'll come down to money, won't it? in fact, take o'brien who's the head of the w. i chose department of immunization said, as we've seen from the coven vaccine, where there is political will, there is funding available to ensure vaccines of scale to the level by unaided. that's what it is in the end, isn't it political? will someone willing to step up and say yes, we have to do this?

absolutely. one thing i would just comment on though is on the coffee board itself, there are a number of health ministers, including ministers from several of the subs. her african countries are gonna, if yo pia, where you know that this is a problem. and they, that they have expressed extremely strong views about the importance of tackling malaria. so i think it's, it's very likely you'd get huge political support from the leadership of countries that have a high burden of malarial disease. but the support we also need is, is the, those, the fill up to fill it, philanthropic organizations, the bilateral donors, the, the richer countries to come in with the money. and we recognize that we are asking people also to come in with funds for coven vaccines at the same time. so we recognize that there is going to be a, you know, that we're going to have to push very hard to, to get these funds spent. certainly in principle that they don't is that i've spoken to and i've heard speaking, what would be in principle,

very supportive of this, but it's how much money is in the bank at the end of the day. you're quite right here who says, isn't it a bell? is it over in nairobi? i know that the curve 19 vaccine roll out is a very different based and it's a, it's a very different situation. but what i would point out is that the roll out of that vaccine across africa has been incredibly poor. i think we all know that we can all see that. does that concern you when you think about whenever it is wanting to roll out a malaria vaccine to those who need it, the most lessons need to be learned. yeah, definitely serious concerns around a commitment from governments and funders at to put men on the table to secure the vaccines, but private data coming a bigger problem because of the current problem that we have resources are being used for college and other priorities of revising the economies and all that. so the timing is not really the best if this happened in about 19 a property,

a expectations would be different. but having said that, i think i agree. i agree that there are bit tied to the motivation to address malaria, as there are as a public health issue is very, very, where we sit around the world. so if you're doing anything on children, whether you use it, whether your summer dial renovation dust or addressing the handle of children, you'll definitely need to be part of this. so there's no way cheap are going to look the other way. when we have something that promises to address to one of the biggest kiddos of children on the continent, a packer color, can i get your phone ready to say, i'm quite optimistic? well, good, take good to hear back a, cathy. can i get your thoughts on the, on the same issue, the idea of, of making sure once the money is there, once the vaccines are, they are actually making sure it gets to the people because that's the sharp end of all of this. pardon the pun. if this is the most important thing, actually getting it into the arms of people when the time comes and, and,

and the coven situation, certainly in africa showing us that, that can be problematic. certainly, that's very important. and that was part of that is, but i'm just thinking that i look in the ongoing by a lot in 3 countries. we find out that my little vaccine is being delivered. i the same level as the deputy vaccine or even at sitting in some conference. so we see that people value mallet of acceptable value in it and i'll prevent malaria. malaria doesn't need that much is not because people at the local level, normally, therefore, we optimistic that weight vaccines are valuable with countries adopting their live . i did that says that there wouldn't be much challenges or that on what estrogen. so we are, we are, we are excited. we're optimistic that this to we get out there and that lives with folks. let's look at the measures as a whole because yes,

a vaccine is one part of it. and as we've mentioned, there will be anti malaria drugs, which are part of it as well. and then i've done a lot of reading today about mosquito nets and how incredibly potent they are. dr. parker, a quick thought from you. first of all, about waxy, maybe can just explain to have years how important and, and, and what a sort of tool these nance are in in the fight against malaria is psychiatric goodness. lady lamb implies, ah mosquitoes in pregnant diligence if, when they leave i use appropriate. they're not called to most people, they prevent malaria. so these are very effective tools, but in my little weed, not have any better to even demand his in birth. but any trials, it's barely got to about 50 percent. if you, casey. so what you're saying is that we are mounted pleasantness. we're not

a pleasant diversion. mother of austin. we are adding additional to the government through less use all of them where applicable. unless keep moving forward, controlling malaria and eliminating melissa helen reese, am i missing anything there? are there any other arrows in the quiver when we want her to fight malaria? well, i think one of the things that to this sort of raises again when we were talking clearly about prevention, which is critically important. it's always the 1st to, for any infectious disease. but i think the other thing we should also think about is treatment. because in many of these endemic areas where they've got seasonal malaria and being able to get children into facilities with the facilities able to rapidly diagnose and treat is also extremely important. the same as true for cove it. so as we think about the continuum of how you tackle a problem on very important issue is to strengthen health services to chain health care workers continuously so that able to diagnose malaria and to give them the

tools to be able to quickly treat malaria cases. because as we said, this isn't even with all these tools together, these are not the 100 percent prevention tools, so we will continue to see malaria in these and hybrid districts dr. bella, do you agree with that? that the needs to be more work done on the treatment side of things and making sure everyone's up to speed education effectively as not under the or a 100 percent. i agree, but are all the listing interventions needs to be needed to be sustained? and the probably been there ramped up to, to sort over how the a combo data will probably knockout more medea transmission events and are from i can add that the issue around a behavior and interventions that old just talked about. if you to use a bed net, your behavior has a lot to do with how effective that been. that will be if you're going to take money or tablets, it depends on how compliant that. but you're personally going to be to be able to

take that medicine and, and that, that is really a challenge for, for those interventions that are, that have been there in use before. so if we have an additional information like the vaccine, where if it's put in your arm are probably there is no, we've got to get it out and they're the only hope and prayer is it lists the effect that we deserve. so that's the reason why was things like implemented because it is going to be really a complimentary additional. and there are probably a supportive of the existing interventions and from their pirates. one of the things that up come out is that are at least from that environment, we've not seen any negative impact on existing interventions. probably that might happen later when people think that what a job and therefore they are safe, their band on their existing intervention. and i think that will be the wrong thing to do. yeah. and probably the programming should be aware of that and make sure you

said priority messaging issue and as sustainable a bit of treatment sustainable a bit of out nets, because we know these interventions have even when that being provided field guides, the ab hidden costs are for example, the distribution of needs in the had it reach areas. how do we trust that people i work in the decision to reach their want as the village in the district. so if the things continue walking together, i think we might end up with better results compared to what is that what has been happening right now with running out of time here. and i just want to ask one more question and up permission if you don't mind to ask a rather simple question. what about going off to the mosquitoes themselves? obviously the net help protect for mosquitoes, but is there any way and maybe dr. pucker? i'll ask you of, of targeting the mosquitoes in the 1st place if that's where the malaria comes from . actually says we documented a lot to in the styling of the dynamics. so it is in molina,

but in africa we started mom. whoa, looking at what can we do different one of the things to do differently to mainstream or to say grow up which to malaria, meaning involve the non traditional pattern us agricultural sic, barbie, completed the road, sick, tardy construction. but in my pass it on, you said boss who's got business contribute to moscow, pretty lincoln to sit down with them and see what they can do to. i'm a new rate. did they? did they, did. they did the unintended effect of the i walk a melinda transmission. so yes, we code. but based on a student there, what is the best is to bring in is they put us together and then work with communities to see how we work together to ensure that it is a litigation project. it was upgraded of knowledge to increasing reading size. i believe i did is for mining waiting on the open mining does result in bidding size

that will lead to increase my my you have transportation. so these are the things we are looking at. we hope that by defense booked on this will bring together the, the 47000000 to live countries. we did not have ministries who have a road to play my leader to look at more district response. we love you. countries on it, looking at that. so does that actionable but the exactly what we do with dependent available tools tucked as a pack, a color, helen race a dallas. it all, but thank you so much for your time today. we've all really learned a lot from this discussion. thank you. and as ever, thank you for watching as well. remember, we're online about 0 dot com, including in the podcast section, where you can now listen to our discussions when, if you'd like, or also plenty discussion at facebook dot com forward slash ha, inside story on twitter. we are at ha, inside story, and at come all a j. e. if you want to drop me a line directly on come all santa maria on behalf of the inside story team. thanks for watching the incident.

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