 Hi, everyone, and welcome to the People's Health Dispatch, where this time we're going to hear more about why the malaria vaccine, which has been approved in Ghana, recently is important. And to tell us more about that, here's Dr. Satyajit Rath. So hi, Satyajit, and welcome. Thank you for joining us today. So, as I mentioned, we recently heard news about Ghana approving a malaria vaccine, and it's made big news because it's something that's been discussed for quite a while, but it has turned out to be a bit different than it was expected. It wasn't a big, big pharma vaccine that was approved in Ghana, but something else. So I wanted to start with maybe talking a bit about why is this news important in the first place? So malaria vaccines have been and continue to be scientifically deeply difficult and problematic for a variety of reasons. Malaria is a very weird parasite. It causes chronic infections. It infects children, particularly in sub-Saharan Africa and causes quite severe illness and deaths in children. But there are other varieties of malaria parasites elsewhere in the world that cause chronic infection with a resultant different kind of illness. And in all of this, conceiving of a vaccine, creating it has always been a problem. Added to this is the problem that there aren't good animal models for testing candidate vaccines. And that makes the development of a vaccine even more difficult. So vaccine design and testing for various millennial illnesses has always been something of a difficulty. And therefore this news four months ago, six months ago of the clinical trial of this most recent vaccine followed by its approval this past few weeks in Ghana is such a major step. Thank you. And as you mentioned, we're expecting this particular news to benefit groups which are quite key. So if I understand correctly, it's a vaccine that's going to be given primarily to children. So that's one thing that's important. Another thing that's important is that and that's something that we rarely see is that the vaccine is being approved first in the global South and rather than in high income countries. So how would you comment more on that? Do you have any more thoughts on who this exact vaccine will benefit most and what's the broader picture of the good news it brings? It is true that this is one of the very unusual instances of a vaccine first being approved for usage in the global South. But we need to keep in mind that it's an odd and exceptional example because it is a vaccine against Falsiparum malaria which is common in the global South, particularly in Sub-Saharan Africa. Number one, number two, it's a vaccine meant for children for really small babies from between about six months to about two years of age. And by and large, when vaccines for this kind of infectious disease have been approved for the global North, they've been approved for travelers to the global South. An example is the vaccine against cholera. Now, this millennial vaccine, since it is a vaccine intended for and tested in babies, is inevitably not going to be attractive to the global North and therefore it's not surprising that it is first being approved in the global South. That said, there are two facts that I would like to point out here. The first is, this is not the first malaria vaccine to be approved for usage. There is a predecessor. The predecessor, which was called RTSS, kind of sort of RTSS. It was also called Moskirix. It was also approved again in Sub-Saharan Africa. It was a vaccine, it is a vaccine intended for false malaria. It is a vaccine to be test used in children. The difference between that previous vaccine and this vaccine is number one, the previous vaccine showed relatively lower protective ability, depending on which data set you look at 30%, 40%, 50% protection as compared to the present vaccine, which is actually, according to the WHO, broken the WHO's golden threshold of 75% protection. So clearly it's an improvement. The second point for us in the broader field of health activism to keep in mind is that the previous vaccine Moskirix was developed by, of course, publicly funded research in collaboration with GlaxoSmithKline and funded by the Gates Foundation. The present vaccine, on the other hand, in its development has partnerships from Oxford University in the United Kingdom in publicly funded research, the Kenya Mental Research Establishment, the London School of Hygiene and Tropical Medicine. In other words, it's a much more publicly funded research. Moskirix was also developed, I hasten to remind everybody, in by coordination from Pat in collaboration with the Gates Foundation. How this difference in the developing consortia for the previous generation vaccine versus the present vaccine will play out in terms of accessibility costs, how it will play out in terms of volume of manufactured, particularly given that this vaccine, what's been called R21 matrix vaccine, is being manufactured by the Serum Institute of India, here in India. How all of that is going to play out in terms of accessibility, both in terms of volume of manufacture as well as in terms of cost per dosage at the level of actual implementation, all remains to be seen. So those are differences that we should underline. Just a last point, scientifically, this vaccine is actually simply a sort of refined version of the previous vaccine. It's not a vaccine based on a completely different platform or a completely different target. It's the previous target. It's the previous technology, tweaked and refined in a variety of ways to be a little more strongly generating an immune response. Thank you. And I think the point that you make about the public funds that were used to actually put this vaccine out, it's a very important point to stress all over again in the light of COVID-19, but also broadly. So my last question would be, do you have any thoughts on how this research could continue what would be the important steps to keep it public and to keep it accessible to all? So clearly all of this research is founded on decades of publicly funded research in multiple countries across the world. And therefore for any one developer at this stage to say that they have developed something that is not obvious to the art and field and is therefore worth patenting and patent and intellectual property protecting is going to be disengaged as the best. We need to point that out from the point of view of policy level health activism. At the second level, I think it's important to demand that as these vaccines get approval for field implementation, that data should be systematically collected and examined for evidence of just what level of protection is afforded, what level of vaccine related side effects are observed, what the actual practical grassroots difficulties are in implementation, especially given the fact that multiple doses of the vaccine for babies are being required. So that's one point about policy, one point about activism led monitoring of data collection and analysis for the efficacy of this particular vaccine. And at the third level, building on the point that I made that this is the same vaccine platform as the previous vaccine. We in activist groups should also focus on the many different vaccine platforms that have been thrown up by the COVID-19 vaccine efforts and those being repurposed. And a case in point is the fact that BioNTech, the German based small startup is building a malaria vaccine built on the mRNA technology platform. And it's quite plausible that if simply magnitude of immune response is going to be a major determinant of malaria vaccine effectiveness, then many of these different platform technologies will be useful and important to test. And we in the activist field should not lose sight of those data coming in, both in terms of the technological issues involved as well as in terms of the intellectual property issues involved. Thank you so much.