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Book Review: The Elusive Malaria Vaccine: Miracle or Mirage?

Malaria kills a child every 30 seconds. The World Health Organization currently estimates 247 million cases of malaria annually, with just under a million dead each year. Most of those are children under the age of 5, living in sub-Saharan Africa. Beyond the enormous health burden , major economic effects are also evident, reflecting in large part the loss of productive capacity due to illness. Malaria is estimated to have reduced the Gross Domestic Product of endemic countries by up to 50% over the last 30 years, compared to non-endemic countries. Today, malaria is largely confined to tropical and subtropical areas of the world, but as recently as 150 years ago it was also found across much of Europe, large swathes of Asia, throughout the eastern United States, and along the Pacific coast as far north as Vancouver Island. Any disease of such import attracts many people who want to cure or prevent it, be they motivated by a desire to do good or to win glory. Toward the end of the 19th century, malaria research was hot: the bloodstream parasite was identified by Laveran in 1880 and the mosquito stages and transmission by Ross in 1897 and 1898, respectively. Vaccinology was also making important strides, including successful vaccines using weakened and killed pathogens. The two fields were synergistic. With the pathogenic agent for malaria in hand, the search for a vaccine was on. Today, over a century later, the search continues. In The Elusive Malaria Vaccine: Miracle or Mirage?, Irwin Sherman recounts the pursuit of a malaria vaccine over the last century, writing from the perspective of ~50 years studying the biochemistry of malaria parasites. The book is both a history and a compendium of information about malaria vaccine research, supplemented by basics in parasite biology, immunology, and vaccinol-ogy. Key discoveries are described, along with the scientific milieu in which they were made. Approximately half the book discusses contemporary vaccine studies, including the pros, cons, and principal antigens for vaccine strategies that target different stages of the malaria parasite life cycle. Sherman also includes the sort of lore that begins as common knowledge, but then fades into obscurity: the idiosyncrasies of bird, rodent, and monkey malarias; immunological observations made during malaria therapy for syphilis…. For those who enjoy such tidbits, the book is a delight. The book is engagingly written and should be of great interest not just to …