[bell-cot]

The important lead paragraphs:

> Giving young children the world’s first malaria vaccine RTS,S/AS01E alongside antimalarial drugs before the rainy season has led to a significant reduction in life-threatening malaria cases and deaths for over five years, according to a landmark study.

> Results published in The Lancet Infectious Diseases show the vaccine-drug combination reduced clinical malaria episodes, including cases of severe malaria in children and deaths, by nearly two-thirds compared with either method given alone in settings of highly seasonal transmission.

> The study began in 2017 in Burkina Faso and Mali, two countries with a very high burden of malaria, and followed more than 5,000 children over a total of five years.

Like pretty much anything involving malaria, I'd say this is a temporary victory at best. Malaria has a long history of developing drug resistance. And vaccine resistance could well prove similar.

[acdha]

> Like pretty much anything involving malaria, I'd say this is a temporary victory at best. Malaria has a long history of developing drug resistance. And vaccine resistance could well prove similar.

We certainly shouldn’t give up on new research but I wouldn’t be so quick to reach the pessimistic conclusion. Vaccines are more robust than drugs and these cocktail approaches are good for requiring multiple favorable mutations to escape.

I do wish Intellectual Ventures had invested in the mosquito laser for more than a TED talk, though: there are plenty of bad things other than malaria and nothing evolves resistance to lasers.

[bell-cot]

> We certainly shouldn’t give up on new research but I wouldn’t be so quick to...

My point was: We should continue with research as if this vaccine-drug combo had proven useless - because even if it is somehow perfect now, malaria might well evolve resistance to it faster than the Next Effective Thing can be discovered and brought to market.

[acdha]

I guess my thought was just to avoid giving the impression that this isn’t a big advance for millions of people even if it’s not perfect or permanent.

[BurningFrog]

The solution of replacing the few mosquito species that can spread malaria with other mosquito species should work. It's hard to see how the parasite will work around having nowhere to live.

It will probably take a few decades - and many million dead Africans - before the world gets over it's squeamishness around that.

[HWR_14]

I doubt it will take decades. There are attempts going on right now with releasing genetically engineered mosquitos that should take care of the population. However, because this is the attempt to use genetic engineering to wipe out a species they are testing on some isolated islands to make sure we aren't destroying other species and it technically works before releasing it into the wild.

That is, it's not squeamishness about the goal. It's making sure we don't mess up the execution and wipe out other species in collateral damage and/or have the mosquitos develop a countermeasure that causes it to be harder to accomplish because we had an imperfect initial attempt.

[BurningFrog]

I see a lot of squeamishness about deliberately exterminate certain mosquito species.

That is an absolute taboo for many people. How powerful they'll be in the final determination remains to be seen. Hopefully you're right.

For something that kills 1700 people a day, I would wish for a lot of urgency and corner cuttings!

[HWR_14]

Releasing something to intentionally wipe out a species, should it prove not to correctly contained, can cause a lot of damage. I would hate for corners to be cut.

[BurningFrog]

In real world decisions, you have to account for both costs and benefits.

If we ignore the cost of 1700 people dying per day I agree with you. But to me the chance of saving a human life every 50 seconds vastly outweighs the risk to some random local mosquito species.

[HWR_14]

The risk is that the species eradication leaps between species and wipes out other species we want to preserve. Seems like a negligee risk to me, but maybe it is real?

[wil421]

Not sure about Africa but in the US the problematic mosquitoes are non-native. In the Florida Keys they’ve been piloting releasing genetically modified males. According to the article when they mate the offsprings are male only. FYI, the males don’t bite.

[1] https://fla-keys.com/news/article/10845/fkmcd-oxitec-mosquit...

[civilitty]

> Like pretty much anything involving malaria, I'd say this is a temporary victory at best. Malaria has a long history of developing drug resistance. And vaccine resistance could well prove similar.

Combination therapies like this one with multiple mechanisms of action are far less likely to develop drug resistant strains. They’re increasingly used to treat HIV, cancer, STDs, and other diseases that are even more adaptable than malaria.

[zabzonk]

Perhaps so, but that doesn't mean that we should not keep trying. Many strains of bacteria (for example - yes, I know the malaria parasite is not a bacterium) develop antibiotic resistance, but others do not. This makes Mani antibiotics still useful.