We were delighted when Dr. Christian Loucq, director of the PATH Malaria Vaccine Initiative stopped by the ONE office last week for an interview in honor of World Malaria Day. He candidly shared his experiences from around the world and his thoughts on vaccines, advocacy and the future of the fight against malaria.
How did you come to PATH, and what work are you doing for them currently?
I am the director of the PATH Malaria Vaccine Initiative (MVI). At MVI, our mission is to speed up the development of malaria vaccines and ensure they are available in the developing world. I started my career as a young doctor in Africa and worked in sub-Saharan Africa for six years. I have spent most of my professional career working in the vaccine industry in Europe, India, Thailand and China.
My passion has always been in vaccines. Vaccines are one of the best tools ever developed against infectious diseases and for developing countries. I came to PATH because I wanted to be able to combine my interest and expertise in vaccines with service for a nonprofit organization. I have worked at PATH for more than four years and it has been an extraordinary experience. We have been able to achieve a lot. We have had an incredible opportunity to build a team of experts with scientific, management and field experience.
With so many global health challenges out there, why is a malaria vaccine important?
One number: 800,000. That’s roughly 800,000 people who die each year because of malaria. Most of those 800,000 are in Africa, and almost all of those deaths are to children under the age of five. This is simply unacceptable today. Malaria poses serious challenges for development and this must also be considered. If people did not have to spend such a lot of money on the treatment of malaria, it could be spent in other places for development.
It’s easy to talk about bednets and treatment for malaria, but a little harder to sell a product that’s still in development. What messages do you recommend for advocates?
Let me quote Rob Newman from the WHO, who I think said it best: “The research of yesterday gave us the tools of today and the research of today will give us the tools we will need tomorrow.” We already see problems of resistance in malaria and other diseases; if we don’t invest today in new tools, we will have a bigger problem down the road. Some of the best results we’ve achieved in the field of infectious diseases — smallpox eradication, the elimination of polio in many countries — those results have all been the victory of vaccines. Today, we still have big challenges that need vaccines.
We were proud cheerleaders of PATH’s development of a meningitis vaccine, and are also excited about the rollout of new pneumococcal and rotavirus vaccines. What do you think is driving this energy around vaccines?
I still remember back when Jonas Salk and Albert Sabin developed versions of the polio vaccine, and mothers would run across the street to come shake their hands and thank them for their work. The meningitis vaccine is a new model. The concept of being able to form a partnership with WHO and getting manufacturers to commit to be able to develop a low cost vaccine and make it available for something like 40 cents a dose — that’s fantastic. And I think energy comes when we see new vaccines developed one after another, creating hope and momentum.
Your bio says you’ve lived and worked in Algeria, Belgium, Chad, China, India, the Netherlands, Niger, Switzerland, Thailand, the United States and the United Kingdom. What’s been your favorite place to live, and what place has most informed the work you do now?
You know, I’ve thought a lot about that question, but I’m not sure I have one answer for you. In each country I have met great people. Each culture and environment is an opportunity. All places, depending on how you approach them, bring something great to offer.
I did my training as an MD in Europe, and in Europe we had everything that we needed to save as many people as possible. When I came to Algeria as a young doctor, the first thing I had to witness was a child dying, and that was something that has always stayed with me and has been one of the big drivers of what I decided to do with my career.
My first posting was in a very remote place in North Africa. We had a very small hospital in the mountains, and I remember a mother who brought her sick child in with meningitis. We fought day and night for a week, with the child between life and death. In medicine you always have that moment when you’ve made it, when you realize the child is going to be OK. The mother came back to us and offered eggs, olive oil and an envelope with a very odd amount of money as a means of thanks. We accepted the eggs and olive oil because those were gifts, but we would never accept money as a matter of principle. We asked her, “why the odd amount of money?” and she told us that her husband was working in France, and that was the amount of money that he had sent for the period during which we took care of her son; she wanted us to have it. That was an experience I’ll never forget.
The non-profit world has a tendency of painting pharmaceutical companies as “the bad guys.” From your experiences in the industry, what role do they have to play in global health?
The pharmaceutical industry brings two things: a very strong, high level of expertise, and a commitment to making good products. I would have not worked there if that were not the case. The same quality products that go to the US market also go to immunization programs in Africa. A vaccine can be developed and discovered in a lab and produced in a small amount, but getting millions of doses to the field requires expertise.
We always see industry as a place that is making profit, but they also have a mission. This idea of corporate social responsibility is growing in major organizations. This is something that is very important. They’ve seen that people working in their organizations are more committed and loyal to their work if they see their organization doing something good of that kind.
Public-private partnerships are very important. When the first malaria vaccine becomes available, it will be used in Africa only and the market there is quite limited. Without public-private partnerships, the malaria vaccine will not be able to get to the people who need it most. At the end of the day, one has to keep in mind the first organization that is able to develop a malaria vaccine will generate a lot of good will.
What’s next for the malaria vaccine, and what’s next for you?
In six months, we will have the first set of data from the RTS,S Phase 3 trial and then we will have a better sense of the potential impact of the vaccine on mortality in children aged 5 to 17 months. But we are already working on the next generation of malaria vaccines. It takes 10 to 15 years to develop a vaccine, so we are already working on new products, hoping to reach an efficacy of 80 percent with a vaccine. We are also already working on other research such as figuring out a way to protect mosquitoes during their blood meal, to interrupt transmission. We want to figure out a way to develop antibodies to stop the life cycle of the malaria parasite in a mosquito before it can bite and infect humans.
We need to have the goal of eradication if we are serious about fighting malaria. If we don’t target ending the cycle, we will lose gains. We need new tools if we hope to eliminate and eradicate malaria, and that’s why the development of a malaria vaccine is so important.