Coming in from the cold

Vaccines have featured prominently in the news in recent weeks - and for once it's not the supposed risks posed by the MMR vaccine making the headlines.

A candidate malaria vaccine developed by GSK in conjunction with the Malaria Vaccine Initiative of the Program for Appropriate Technology in Health (PATH) is the first to demonstrate any efficacy against severe malaria in children. There are 300-500 million malaria infections each year globally, resulting in more than a million deaths, 90% of which are among young children in Africa. Malaria kills one African child every 30 seconds.

While much work remains to be done, the clinical trial results suggest that the RTS,S/AS02A vaccine has the potential to save the lives of millions of children under the age of five and could be licensed by 2010.

Just days after these results were announced came the news that a technology had been developed that could eliminate the need for vaccines to be kept in refrigerated conditions and distributed via the cold chain.

Developed by Cambridge Biostability, it uses the principle of anhydro-biosis, which allows cells to be preserved in a dried-out state. The dry vaccine is then reactivated once it is injected into the body.

If the technique proves successful, it would mean vaccines would become more available across the developing world, where it is estimated that about half of all doses are wasted each year because of contamination or exposure to extremes of temperature. A further 10 million children could be protected within existing budgets, experts suggest.

However, it will be five years at least before a vaccine that can be stored without refrigeration will be on the market. If the technology had been available now, the current crisis over the availability of flu vaccines in the US would probably not have arisen.

Having lost 48 million doses - half the nation's annual supply - when the output of Chiron's plant in Liverpool was declared unsafe, US health officials have reportedly been trying to redistribute the remainder of the 55 million doses made by rival manufacturer Aventis-Pasteur among those most at risk, such as the elderly and babies.

That these are the only two remaining flu vaccine manufacturers is largely down to the difficulties in storing vaccines, resulting in high wastage.

Vaccines are not a very profitable business - as they are mainly bought by government agencies margins are low and the global market is only around $6bn a year compared with $340bn for drugs.

But with the demand for flu jabs growing year by year, the possibility of storing vaccines in ambient conditions and the prospect of an effective malaria vaccine, there may yet be light at the end of the tunnel.