A Scientist Behind Vital Research on Malaria Vaccines: Q&A

Professor Kwaku Poku Asante is the Director of Kintampo Health Research Center (KHRC), one of the three research centers of the Ghana Health Service Research and Development Division. Established in 1994, KHRC aims to conduct research that reflects the country’s needs and improves public health. It has 120 senior staff that support the Center’s research portfolio. Professor Asante and his team are leading the implementation of the PMI-supported MalVac and PMC trial, along with the London School of Hygiene and Tropical Medicine (LSHTM). The team is also leading the development of a malaria vaccine research agenda in partnership with the World Health Organization (WHO) and Gavi, the Vaccine Alliance.

We spoke with Prof Asante to learn about his work in the field of malaria, the history of KHRC, and his insights into malaria vaccine research and implementation.

What inspired you to work in the field of malaria research?

I lived in Kumasi, Ghana, during my childhood. Malaria was prevalent at that time, but the full burden of malaria wasn’t apparent to me until I worked as a clinician at Kintampo Municipal Hospital. The first thing you would see when entering the hospital ward were tubes of blood, which signified transfusions for many children, especially during the rainy season. It was common for children to be rushed in with febrile convulsion due to severe malaria. I saw first-hand the burden of malaria and its impact on children and families, and I wanted to do something about it. This led me to the field of malaria epidemiology, and my work on malaria interventions and clinical trials.

What were some of your earliest research interests and experiences with malaria research?

I was first involved in malaria research through a study to investigate the burden of malaria in rural communities with some of my senior colleagues. We wanted to understand and characterize the burden of malaria, as well as malaria’s impact on hemoglobin levels. It was surprising to find out that six out of every ten children we came across had malaria parasites, and the prevalence of anemia was very high. We transitioned to thinking about possible interventions and our team supported clinical trials for various drugs and vaccines. These early studies built my knowledge of malaria epidemiology and the foundation for my future research.

What do you see on the horizon for the implementation of malaria vaccines, and what are some challenges that you anticipate?

These are very exciting times because we now have two malaria vaccines with the potential for significant impact, the RTSS vaccine and the R21 vaccine. During the pilot evaluation of the RTSS vaccine, we saw about 13 percent reduction in all-cause mortality. Considering many children die of malaria each year, this translates to a large number of children who could be saved. I believe the best way for me to contribute to malaria vaccine research is to test the vaccines in populations that need them the most to maximize their effectiveness. The Covid-19 pandemic taught us the importance of having multiple interventions and strategies to fight disease. These vaccines can help us cover more age groups and populations and can be used along with other malaria interventions.

Could you share a bit about the history of Kintampo Health Research Center’s involvement with malaria vaccines? In addition, what contributions do you envision the PMI Insights MalVac and PMC trial will make to malaria programming and policy in Ghana and globally?

In the area of malaria, KHRC contributed to some of the first large-scale trials to study the safety and efficacy of the RTSS malaria vaccine Phase II and III trials in Africa from 2006 to 2015. KHRC was subsequently selected by the World Health Organization to evaluate the feasibility, safety, and impact of the RTSS malaria vaccine in Ghana.

We are now conducting the malaria vaccine (MalVac) and perennial malaria chemoprevention (PMC) trial to evaluate the efficacy of combining the malaria vaccine with PMC. PMC is the administration of antimalarial drugs to children at high risk of malaria, often at the same time as routine vaccinations. Previous studies in Burkina Faso and Mali combined the malaria vaccine and seasonal malaria chemoprevention (SMC), which is administered to protect children from malaria as a result of the rainy season. The data from these studies showed a significant reduction in cases of malaria and all-cause mortality. In the MalVac and PMC study, we are testing whether combining the vaccine with PMC will also help reduce malaria cases. Along with other countries, Ghana is waiting on this study to make a firm decision on how to implement PMC and the malaria vaccines. This study has the potential to inform guidelines around malaria vaccines and PMC globally.  If this study demonstrates that the combination of malaria chemoprevention and malaria vaccines is efficacious and can be delivered within the health system, this can help us reach our goal of malaria elimination. It’s exciting to bring two interventions (vaccines and chemoprevention) together for coordinated implementation.

Prof Kwaku Poku Asante is a medical doctor and malaria epidemiologist. He received his medical degree and a Master’s in Public Health from the University of Ghana, and went on to do his PhD in epidemiology at London School of Hygiene and Tropical Medicine (LSHTM). Prof Asante also holds part time positions at the University of Ghana School of Public Health and LSHTM.

Cover photo: Prof Kwaku Poku Asante. Photo credit: Shared by KHRC Communications team

Launched in October of 2020 by the U.S. President’s Malaria Initiative, PMI Insights works to generate evidence and data to inform the global malaria community of best practices; to identify and facilitate stakeholder alignment around the most pressing gaps in malaria control and elimination policy, strategy, and implementation guidance; and to disseminate of results in a clear and actionable way.