Friday, August 9, 2013

An Unreasonable Man's Triumph of Imagination


“Once you have proven the concept, everything else is engineering. The stakes are so high. A baby dies every 60 seconds from malaria. I can’t imagine that some engineering genius can’t figure these things out. Let’s go for it.”

 The Washington Post today with another great piece on Steve Hoffman’s malaria vaccine breakthrough @  

          Yesterday, the journal Science published the results of Steve Hoffman’s newest clinical trial showing that for the first time ever, 100% of the trial volunteers who received a high dose of his unique vaccine were protected.  In the last 24 hours, CNN, Reuters, U.S. News and World Report and dozens of news outlets around the country ran headlines like: “Sanaria’s Malaria Vaccine Yields Unprecedented Protection in Clinical Trials.” Or “New Malaria Vaccine the First to Offer Complete Protection.”   @   Major foundation funding has quickly begun to return.   The lead researcher for Steve’s principal competitor, the giant pharmaceutical Glaxo Smith Kline was quoted as saying “This is a really important, really exciting proof of concept.”

Nearly three years ago Public Affairs published my book, The Imaginations of Unreasonable Men, about Hoffman’s quest to develop the first completely effective malaria vaccine that could eradicate malaria as one of the world’s leading causes of illness and death for children.  @

            I was drawn to the story specifically because of the parallels to our work – knowing that something was solvable, knowing that existing solutions worked but were hard to scale, and that doing so might seem expensive, unrealistic or unreasonable.  Hoffman’s standard - that good is not good enough – was akin to our view that feeding kids is not good enough but that we need to end childhood hunger. I knew there was much to learn from him.

            The book was published just as Steve was taking his vaccine into clinical trials. His approach, which depended on extracting weakened but live malaria parasites from the dissected salivary glands of mosquitoes, was ridiculed in some quarters as impractical to produce and administer.  The trials went badly. The vaccine, administered by injection failed and the volunteers exposed to malaria contracted it (though they were immediately cured by aggressive medical intervention according to standard protocols.)  The funding for Steve’s work dried up.  He faced some dark days.

            But Steve knew that the weakened parasite triggered immunity to protect against malaria when they entered the body through multiple mosquito bites. So he refused to give up, even as some abandoned their support. Instead he doubled down.  He increased dosage and settled on an approach truly beyond imagination: administering the vaccine through an IV, something entirely impractical across Africa where children need it the most.  But his strategic objective at this stage was not scale, it was “proof of concept.” It's an approach very much at the core of our No Kid Hungry campaign.  Now that proof of concept has been affirmed, new funding will be devoted to additional trials, scale and sustainability. 

The history of malaria suggests no more than cautious optimism is warranted at this point. There is still a long way to go.  But Steve Hoffman’s long journey has been dramatically accelerated by the proof of concept strategy we share.


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