London School's 20-fold grant increase covers DNA vaccines to politics

Malaria should shiver at a new attack to be mounted against the disease.

By | August 25, 2000

LONDON, August 25 (Science Analysed). The Bill and Melinda Gates Foundation's recent US$40 million grant to the London School of Hygiene and Tropical Medicine for work on malaria stretches all the way from research to implementation, Professor Eleanor Riley of the LSHTM and co-director of the malaria project, has told BioMed Central.

Riley explained that the money would support three different activities. One will be field research on new drugs, vaccines and insecticides for their ability to control malaria. "The problem with existing funding is that it has been spread over a lot of different institutions, and it's always taken a long time to get sufficient money together, from different people. For each trial you've had to go back to the drawing board to create a new consortium."

"The research component will be mostly with institutions in Africa, obviously" said Riley, "but the preclinical trials will be mostly with hospitals of tropical diseases in London."

Second will be a training component "to develop regional training centres, to cover research and control in East, West and Southern Africa; and third, a policy initiative, to make sure that the research we do is actually translated into health policy in endemic countries. In other words, implementation."

In cash terms, "In the past we'd had to think of a large grant as something between £750 000 and £1.5 million, so it's twenty times bigger than the normal grants we get." The grant is believed to be the largest of its kind given to a British university.

In the pipeline there are "two or three vaccines kicking around only one of which has gone into field trials [the RTSS vaccine developed by SmithKline Beecham together with the US Army], and there are one or two recombinant DNA viral vaccines which are just about going into their first humans. They are undergoing safety and immunogenicity tests now, and after that some challenge trials, and if they look good, they will go into our system." And there are a couple of recombinant protein vaccines as well that are less far advanced."

"On the drugs side, there are new combinations to deal with increasing resistance. The pharmaceutical companies are going back to their old antimalarials, the ones that are losing potency, and putting them together in new combinations. Chlorproguanil is the furthest they've gone back — it's been out of production 10 or 20 years." One example is 'lapdap', a combination of lapudrine (chlorproguanil) and dapsone; and another, a combination of old drugs plus artemesinin derivatives (from Qing Hao Su, the Chinese herbal remedy). Artemisinin alone is not enough for Africa, as it has a high relapse rate and is not particularly effective for severe malaria, which kills some million infants in Africa each year.

How did the grant from the Bill and Melinda Gates Foundation arise? Riley says that the school had an indication from Bill Foege, an advisor to the Foundation, that its skills and concerns would merit support, " . . . so we put in a two-page proposal, and were told that the Gates Foundation gets several thousand of these a week, and that we wouldn't necessarily hear anything. For about three months we didn't hear anything. Then we had an e-mail, saying the Foundation was interested — and we had about six weeks to put a detailed proposal together. From then on we kept in regular touch. Their office is quite small and people are very accessible."

"What this grant will do is to allow us to move forward much more quickly with promising drugs or vaccines, without having to go back to the funders at every stage and reapply. That's what takes so much time in current research funding situation."

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