Evidence of meeting #64 for Foreign Affairs and International Development in the 41st Parliament, 2nd Session. (The original version is on Parliament’s site, as are the minutes.) The winning word was cameroon.
A recording is available from Parliament.
11:55 a.m.
NDP
Hélène Laverdière NDP Laurier—Sainte-Marie, QC
Thank you very much, Mr. Chair.
Mr. Lucard, we talked very briefly about a potential vaccine. Mr. Verhoosel and the senator might also like to comment. Where are we with the possibility of having a vaccine some day?
11:55 a.m.
Executive Vice-President, Medicines for Malaria Venture
Hervé may want to help me with this, but at the moment there is a vaccine in development, known as RTSS. However, recent clinical trials have shown that the vaccine is only partially effective and needs to be given over multiple years in order to be fully effective.
There is a role for that vaccine to play. At the moment the World Health Organization is deciding what the role is for that vaccine, but a fully effective vaccine as we know it for most other diseases is not in the immediate future for us at this point. There will be a role for vaccines, and it is important to continue the development of vaccines.
In the meantime, therefore, in fact on the question about whether we are talking about preventative drugs, indeed, we are. In the Sahel region in Africa, for example, we're finding that giving a dose of two older drugs together, three times, once a month over the rainy season, is having a huge preventative effect of between 75% and 85% for a cost of about 25¢ per month. This is not available to those who would have to take it constantly. This is in seasonal areas.
As a global community, we're beginning to think slightly differently about how to medically prevent malaria. These are the areas that we're beginning to develop, along with the use of bed nets and other interventions.
Does that answer your question?
Noon
Pierre Flambeau Ngayap
I would just like to add that I began my research and development career in France, with the pharmaceutical group Sanofi. Based on that experience, I would invite you to be very careful in raising hopes about vaccines, as we can often do. As long as a vaccine has not been demonstrably perfected and as long as it has not been definitively proven to be effective, the research must go on.
In a nutshell, we must continue to encourage research into a vaccine, with all the difficulties we are aware of, because the anopheles mosquito does not have a simple reproduction cycle. So the vaccine will be as difficult to research and develop as it is for an AIDS vaccine and for other pathologies.
My advice to you remains that, as long as the vaccine has not been definitively discovered, perfected and made effective, we have to continue to put our efforts into prevention. Prevention does not cost a lot.
Noon
Representative to the United Nations in New York, Head of External Relations, Roll Back Malaria Partnership
The research on a vaccine for a parasite is always very difficult and costs a lot of money.
I would like to inform you here that the Bill and Melinda Gates Foundation has invested a lot of money in that research and development. That's research in different projects, the one in particular that Andrea was talking about but also other candidate vaccines that are potentially in the pipeline.
If, and I say “if”, WHO and further European authorities decide that the vaccine today will work in, let's say, 50% of the cases and will be used in the future, then we hope that Gavi would potentially put that vaccine on the list of the vaccines that it will use. As the senator says, that will be an additional tool to complement the bed nets, the test, the residual spray in the house and, obviously, the medicine afterward.
It's not yet the end of malaria but that will save thousands of people.
Noon
Conservative
The Chair Conservative Dean Allison
We're going to finish up with Mr. Trottier. You have five minutes, sir.
June 4th, 2015 / noon
Conservative
Bernard Trottier Conservative Etobicoke—Lakeshore, ON
Thank you, Mr. Chair.
My thanks to the guests for being here today.
Following on Ms. Laverdière's questions, I am going to try to understand a little more about the development of a malaria vaccine.
What is the difference between malaria and other diseases afflicting the world?
Are we seeing mutations in the disease? Are we still trying to develop new vaccines. In what way does the nature of malaria make that task so difficult?
My colleague the senator could begin, perhaps.
Noon
Pierre Flambeau Ngayap
The difficulty with malaria is that its development cycle is long and it involves a number of factors. You cannot get malaria unless you are bitten by what we call an anopheles mosquito, a female mosquito.
However, in order to pass on malaria when it bites you, that anopheles mosquito must have ingested the blood of someone who already has malaria. The mosquito itself is not the carrier of the malaria parasite. The parasite has to come from an already-infected patient. So there are three factors: a sick person, an infected human, a female anopheles mosquito biting you, and a second person to whom the parasite will be passed. There is no direct transmission from person to person.
In that three-part chain, the parasite is transformed, both in the infected patient and in the mosquito, because, when that mosquito bites, the parasite is transformed inside the mosquito and when the mosquito passes it on to another sick person, there is a transformation as well. There are so many mutations between the three elements that it is difficult to find the appropriate sequence in order to identify the vaccine.
Noon
Conservative
Bernard Trottier Conservative Etobicoke—Lakeshore, ON
So it’s complicated, it’s difficult, but it is an objective that we need to have. This research still needs to continue.
We can do a lot of things for prevention, things that are not expensive, as you said, because it will likely be very difficult to eradicate malaria completely.
12:05 p.m.
Pierre Flambeau Ngayap
I agree with you. We must continue to encourage research, because vaccination is the ultimate solution in the medium term.
We are going through a stage like the one that preceded the current combined drug treatments. For over 50 years, a prevention treatment used chloroquine. For 50 years, that worked.
But when the resistance started to build up, there was a transition phase of 10 to 15 years when there were no alternatives. Research needed to be sped up to find solutions with drug combinations. The transition phase must also be found to manage the period before the vaccine. Before the vaccine is found, we must continue to focus on prevention and on treating the reported cases.
12:05 p.m.
Conservative
Bernard Trottier Conservative Etobicoke—Lakeshore, ON
Okay. Thank you.
Where are we on treatment? In the documents provided by MMV, I read that African children can have malaria six times a year. Does that mean that it is treated six times a year with the same drugs? Is treatment for malaria being improved? I remember hearing that the success rates of the treatments were not very high. Are there tangible measures showing that the treatment is now much more effective than before?
12:05 p.m.
Pierre Flambeau Ngayap
The success rates are quite high today, over 80% to 85%, for both uncomplicated and severe malaria cases. Uncomplicated malaria cases are treated with pills taken orally for three to five days. If the treatment starts early, the disease stops completely after five days. You just have to follow up with boosters. In severe malaria cases, the same drugs are used, but parentarally through IV drips. In those cases, treatment takes seven to ten days and we obtain the same results, a success rate of over 80%.
12:05 p.m.
Conservative
Bernard Trottier Conservative Etobicoke—Lakeshore, ON
Is the objective a 100% success rate? Is that a target?
12:05 p.m.
Pierre Flambeau Ngayap
We can come close to a 100% success rate when the patient is looked after quite early. The longer it takes to start treatment, the more likely the treatment is to fail.
12:05 p.m.
Executive Vice-President, Medicines for Malaria Venture
I would also add that indeed one of the major activities that we're undertaking is to try to make the course of treatment much simpler and much shorter. It's not only a question of if a medicine is entirely 100% effective, but that you have to take it for a long period of time, which people don't do. We're working very hard on coming up with a single dose point of care cure. This is a very complex activity, and as the senator has said, it's a very complex disease. But this is also something that we're undertaking to make the treatment much stronger.
12:05 p.m.
Conservative
The Chair Conservative Dean Allison
Thank you.
Thank you, Mr. Trottier.
To our witnesses, thank you for taking the time to be here today to discuss this very important issue.
12:05 p.m.
Representative to the United Nations in New York, Head of External Relations, Roll Back Malaria Partnership
If I may, Mr. Chair, there's an open invitation, if this committee or some of its members are in Africa, to come to see us, which is the best way to understand. We would be more than happy to organize a visit, if some of you are in Africa or in the endemic zone.
Thank you.
12:05 p.m.
Conservative
The Chair Conservative Dean Allison
I guess if we're at the United Nations in New York, we could also come to see you.
12:05 p.m.
Representative to the United Nations in New York, Head of External Relations, Roll Back Malaria Partnership
Bring a bottle of Canadian wine, and yes.
12:05 p.m.
Voices
Oh, oh!
12:05 p.m.
Executive Vice-President, Medicines for Malaria Venture
And MMV is holding its expert scientific advisory committee meeting in Canada next June, to which you are also all invited, if you're interested in finding the Canadian and global experts in this field.
12:05 p.m.
Conservative
12:05 p.m.
Pierre Flambeau Ngayap
My door is open all year round.
12:05 p.m.
Conservative
The Chair Conservative Dean Allison
We're going to suspend for a few minutes and then we'll come back in camera to talk about our protection of children and youth draft report.
[Proceedings continue in camera]