Jaajef Madiba and all those interrested ion the subject,
I have come more details of the Colombian vaccination I mentioned in my last posting on the issue: Manuel Patarroyo, and also a useful discussion list for anyone interested in researching for more information on Malaria (see below).
Yeenduleen ak jaama
Tony
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Manuel Patarroyo- Colombia
Manuel Patarroyo, a Colombian research scientist, has developed the world's first safe and
effective malaria vaccine. The vaccine is the first against a parasite.
The vaccine has been proven effective between 30 and 60 percent of the time to those over
one year old. At a 30% effectiveness rate, the vaccine could protect 100 million people
from malaria, and could save 1 million lives out of an annual death toll of 3 million. No
vaccine has ever protected that many people.
Patarroyo claims that his work and the efforts of his Third World colleagues are often
treated with a condescension bordering on racism by northern scientists. He points out that
it took his Bogota laboratory four years to develop the world's first safe and effective
malaria vaccine, but six years to have it recognized.
There were discussions with a major pharmaceutical company to manufacture the vaccine
in Switzerland, but that would have made the price very high. Patarroyo insisted that the
vaccine be produced in Columbia, in order to keep the price low. If produced in Europe or
the US, the price per dose would have been $10, but by producing the vaccine in Colombia,
it is estimated that it will cost 40 cents per dose.
Rather than profit from his discovery, Patarroyo turned the patent for his vaccine over to
the World Health Organization (WHO) for free, because he felt that the benefits should go
to mankind, not to large pharmaceutical houses or rich investors.
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Scientific American
Vol. 275, no. 6, December 1996, pages 28-29
Profile: Manuel Elkin Patarroyo, the man who would conquer
malaria (by Marquerite Holloway)
Patarroyo developed a vaccine for malaria by synthesising peptides
identical to those of the virulent strain of the malaria parasite. This
article reveals something of the man, his research, and the controversy
surrounding his vaccine.
MANUEL ELKIN PATARROYO
The Man Who Would
Conquer Malaria
The turn-of-the-century stone building is rotting inside, floorboards dusty and
dilapidated, pigeons roosting in the eaves. There are no windows in the moldy sills,
and weeds are thriving--even this structure in the middle of Bogotá, Colombia,
suggests the jungle is not so very far away. "This is how my buildings always come,"
says Manuel Elkin Patarroyo, proud of the efforts that have transformed other nearby
structures into a charming enclave, complete with gardens, that recall the Pasteur
Institute in Paris--a similarity that delights Patarroyo, because he says that it irritates
his rivals there.
Once restored, this addition to the Institute of Immunology at the San Juan de Dios
Hospital will permit Patarroyo to expand his research empire and to begin
mass-producing the source of his fame and his controversy: the malaria vaccine
SPf66. But the immunologist does not want to dally in the ruined building and talk
about whether the world is going to want such vast quantities of the compound. The
day is slipping away, it's already 10 o'clock in the morning, and there are labs to dash
through and years of work to review.
Patarroyo has a talent for transforming more than architecture. In the decade since he
appeared on the international immunology scene, he has ridden innumerable highs
and lows. Currently, in the eyes of many researchers, he is down again--this time for
good. The most recent trial of SPf66 (published in the Lancet in September) failed:
Thai children given several inoculations were no more protected than those given
placebo. This finding follows a 1995 study of young children in the Gambia that also
found the vaccine ineffective.
But Patarroyo has rebounded before. And anyway, to his mind no such thing as a
down period exists--no matter what the studies find. His spirit is irrepressible, as is
his belief that he does not have to answer his critics, that all will be made clear
eventually. "I don't care. They cannot touch me. It is their problem," he states
emphatically. "My enthusiasm will not leave me for a minute. The opposite! They
don't know what a favor they do me."
Then he is off again, dashing through another lab and sliding down the length of a hall
to answer a telephone. In rapid succession, he gives a tour of the molecular modeling
room, the place where work on tuberculosis and on leishmaniasis is being conducted,
and the "peptideria," where the synthesized peptides that form the basis of the
malaria vaccine are stored. He also points out myriad other labs and the entrance to
the restricted area where SPf66 is made. "I usually arrive at eight in the morning, and
I leave at 10 P.M., Saturdays included. It is not unusual for me, because it is as I
want it to be," he says, pausing in front of a mural, one of the many works given to
the institute by famous Latin American artists. "If you are doing what you want and
what you like, you do not feel a tension. My wife and my family are used to that."
A group of his colleagues passes at that moment, and Patarroyo ruffles their hair,
slaps them on the back, teases them. They laugh and joke with him. He explains--still
for a moment against the swirling, colorful backdrop of "A Sense of Immunology," by
Colombian painter Gustavo Zalamea--that he sets up competitions in order to get
work done more quickly. He has promised trips to Cartagena, a beautiful city on the
coast, or seats at one of the Nobel ceremony dinners if his researchers finish projects
ahead of schedule. "But I tell them, 'You son of a gun, if you want to go the Nobel,
you have to buy a tuxedo, because we are not going to be underdeveloped,' " he
laughs.
Patarroyo refers often to his position as a Third World scientist in the First World
research community. Yet he is in a very privileged situation. In Colombia, Patarroyo
is a national hero; according to a magazine poll, his popularity exceeds that of his
good friend, author Gabriel García Márquez. His funding is guaranteed by the
government, as is his access to a large population of owl monkeys, some of the only
animals that can serve as hosts for the malaria parasites that plague humans. Unlike
many researchers whose finances are linked to their results and to being politic,
Patarroyo really is free to ignore his critics.
He is not free, however, to ignore the realities of life in Colombia--where numerous
guerrilla groups vie for power, where the drug trade bleeds into every activity and
where the magic realism of García Márquez can seem prosaic. This summer one of
Patarroyo's shipments of white powder--that would be SPf66--was replaced with
vials of a quite different white powder. And a few years ago Patarroyo and his family
encountered guerrillas on a drive home to Bogotá from some pre-Columbian ruins. "I
was captured for five hours because they wanted to talk to me," Patarroyo says,
making light of the experience, his voice perhaps more quiet than he realizes.
But what makes him most happy about his notoriety, Patarroyo continues quickly, is
that young Colombians are becoming interested in science. Another poll pronounced
that 67 percent of the nation's kids want to be scientists. "What other success could I
claim better than that one? To have brought into this country a consciousness,"
Patarroyo exclaims. "So for the children, rather than being Maradonas [the Argentine
soccer great] or rock stars, no! They want to be scientists, and I think that is very
important in our country."
Patarroyo himself had a very particular vision as a youth, as he tells it: "It was when I
was 11, really, that I liked chemistry so much. And my dream was always to make
chemically synthesized vaccines." His parents were both business people and wanted
their children to be the same; they ended up with five physicians, one nurse and one
child psychologist among their progeny. Although Patarroyo opposed his parents'
business values, he acknowledges that his father gave him a firm sense that whatever
he did, he must be useful to humankind.
He left his hometown of Ataco, in the Tolima region, to attend medical school in
Bogotá. He says that he was a mediocre medical student and that it was not until his
internship at San Juan de Dios that he understood what science was about. "It was
so beautiful to me to save lives," he muses. "I wanted to make vaccines because I
wanted to be useful."
In the late 1960s Patarroyo went abroad--something he encourages his researchers
to do. After a short stint in virology at Yale University in 1968, Patarroyo worked in
immunology at the Rockefeller University for several years. He then returned to
Colombia, where he studied various infectious diseases until a colleague urged him to
change his focus. "He said I was an idiot, that I was working on a problem that was
not as important as malaria. Then he gave me the statistics," Patarroyo recounts as he
drives carefully but quickly through the Bogotá traffic to a traditional Colombian
restaurant. Every year as many as 500 million people contract malaria; between 1.5
and three million of them, mostly children, die. Treatment of the disease is tricky,
because strains of the parasite in many regions have become resistant to the principal
drug, chloroquine, and the alternative, Lariam, increasingly appears to be highly toxic.
Patarroyo's approach to developing a malaria vaccine was unusual. Instead of
creating it from dead or weakened strains of the malaria parasite, he synthesized
peptides identical to those used by the most virulent strain, Plasmodium falciparum.
At the time of Patarroyo's initial experiments, few immunologists thought
manufactured peptides could produce a strong immune response. Patarroyo
nonetheless tested various peptides for their ability to produce antibodies in monkeys
and settled on four: one used by the parasite during its larval stage and three used by
the mature parasite to bind to and infect red blood cells. In 1987 he reported that
vaccination protected 50 percent of the monkeys. Controversy subsequently flared
up when investigators could not replicate the results; Patarroyo claims they used a
different compound.
Pausing in the middle of his lunch, Patarroyo starts to sketch a timeline on a yellow
pad, marking the dates of his papers. Right after his first success, he fell into his first
quagmire. "I made a mistake because of my ignorance in epidemiology," he explains.
He decided to vaccinate Colombians but did not set up a double-blind study. He
was roasted by the scientific community for his methodology and for the ethics of
moving so quickly to human trials.
As other results were reported over the years--the vaccine was consistently safe but
proved inconsistently protective--the community continued to divide. "He has always
been a very intense personality, provoking strong emotions," notes Hans Wigzell,
head of the Karolinska Institute in Stockholm. "I have been very impressed by his
capacity to press on. His science is like brute force." Wigzell cautions that even early
on Patarroyo "had the feeling that people didn't understand him. So this is not
something that has just popped up. Personally, I like him."
Even though most studies found the vaccine benefited only about 30 to 40 percent of
patients, many in public health were delighted: 30 percent of 500 million is still a great
deal. SPf66 was held to a different standard than other vaccines because of the
peculiarities of malaria: even people who have developed natural immunity to the
parasite often lose it. As major trials in Colombia and then in Tanzania bolstered the
30 percent or so figure, it seemed as though Patarroyo was vindicated. In 1995 he
donated the rights to the vaccine to the World Health Organization.
Then came the Gambia and Thailand. Although some immunologists maintain they are
not ready to give up on SPf66, they are frustrated by the variability of the results.
"There has got to be some way of evaluating why it is or it is not working," comments
Louis Miller of the U.S. National Institutes of Health.
Patarroyo notes that there may be reasons for the inconsistencies: very young
children's immune systems, such as those of the six- to 11-month-olds inoculated in
the Gambia, are different from those of adults; the vaccine used in Thailand may not
have been identical to SPf66; genetic variability determines immune responses. But,
he adds, he is uninterested in point-counterpoint. He just wants to keep going,
studying ways of improving the vaccine and of developing others. That is the credo of
the institute, he insists: "It is the search for the essence of things. It is not that we are
going to develop a malaria vaccine. It is that we want to develop a methodology.
Really to make vaccines." Then Patarroyo hints that his new research will illuminate
why SPf66 seems so mercurial.
Whatever he may have in the wings, SPf66 remains the only malaria vaccine in trials,
and his work, confounding and controversial, has enlivened the field. As for
Patarroyo, he seems thrilled as always to be a scientist, thrilled to be directing his
laboratory and thrilled to be free to think and transform. "We are really privileged,
scientists," he says, skipping up the stairs to his office a little more slowly than usual
because of lunch. "We get to have intellectual development! How many get to have
that? Most people have to do things they don't like."
--Marguerite Holloway
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Malaria discussion mail server
I have established a malaria discussion mailing list over the Internet. This will provide a forum for
anyone wishing to ask, preach or communicate on the general subject of malaria. At last count there
were about 828 recipients, many of which I had unilaterally joined up myself, and several interesting
discussions have been held. I would like to join up more people if I can get their e-mail addresses. It
is run on a listserver at The Walter and Eliza Hall Institute of Medical Research and can be accessed
by anyone with an e-mail address. To join, you send a subscription message which places your name
on a list of mail recipients. If you later send a mail message to the discussion group, it will
automatically be sent to all the people who have subscribed. As more people subscribe your
message will reach a wider audience, increasing your chances of spreading your message or getting
your questions answered.
Subscribing to the malaria discussion group.
Send an e-mail to [log in to unmask] . In the body of the mail message, you need only type the
single line.
subscribe malaria (preferred personal name)
You could optionally put your e-mail address after the word malaria otherwise the list will use the
e-mail address attached to your message.
Stopping your subscription to the discussion group.
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