By Caroline Somanje

Twenty-five year old Maria Sitole  is  carrying  her  two  months  old Tbaby  girl,  Chisomo  to  Kamuzu entral  hospital  (KCH)  in  the  capital  ty  of  Malawi.  Chisomo  is  running  a high  fever  and  automatically,  Maria uspects  malaria.  Living  in  one  of  the  igh  density  townships  of  Kawale, Maria  knows  better  than  to  hesitate bout seeking medical attention. After ll, malaria continues to be the number ne killer disease and spares no child very 30 seconds in Africa. She needed o  hurry  and  get  there  before  8  am ecause KCH is a government referral ospital in the central region and offers s services for free with only a smaller aying  section.  It  obviously  gets  too rowded  so  she  had  to  be  one  of  the arly birds to catch the worm, even if it wasn't the fattest.

Maria arrives at 7 am but is the ninth in n  already  growing  queue. She unstraps  Chisomo  from  her  back whose  appetite  has  dwindled,  vomits eriodically  and  seems  weak.  The eception  in  a  private  hospital  would as been different with Chisomo  being ushed  to  the  emergency  room  and laced  on  a  glucose  drip  before  the octor saw her. At this hospital, she will have to be guided by the rule; wait your turn or leave!!

After a long wait though, Chisomo and her  mother  are  seen  by  a  doctor  at exactly  11  am.  She  is  given  oral rehydration  salts  to  give  to  the  infant with  a  quinine  injection.  Another injection  stabilises  the  little  one  and she  is  able  to  fall  asleep  after  a  hectic night previously.

While  Maria  waits  at  the  hospital  for further  observation  on  Chisomo,  on doctors'  instructions,  University  of Carolina  (UNC)  Community  Activities Coordinator, Chifundo Zimba, walks up to  her  and  feels  Chisomo's  forehead. She  does  not  need  to  be  told  the diagnosis.

Zimba  chats  with  Maria  about  the possibility  of  making  malaria  history through a malaria vaccine whose trials are  currently  in  their  preparatory stages. She tells her that the trials will target infants between the ages of 6-12 weeks  and  another  age  group  of  5-17 months because the disease continues to  ravage  children  with  one  million dying  every  year  in  the  Sub-Saharan Africa.

Maria seems fascinated at the prospect of having a vaccine for malaria. She and many  other  mothers  cannot  afford treatment in private hospitals because the  bills  are  shocking.  Treatment  at government  hospital  is  a  gamble  because  sometimes  patients  are  told about  the  unavailability  of  drugs.  She realises that once the trial is certified, not only will it provide peace of mind to young  parents,  but  it  could  mean eradicating the disease that has existed her  lifetime  as  well  as  her  parents, g r a n d p a r e n t s   a n d   e v e n   g r e a t   grandparents.

D u r i n g   t h e   c o u r s e   o f   t h e i r   conversation,  Maria  learns  about  the George  Joaki  centre  in  area  18,  a township  within  the  city.  That  is  the centre being set up specifically for the vaccine  trial  and  is  now  in  its  final stages. It will need 1,600 babies as case studies to be monitored for two and a half  years  in  phase  three  of  its  trials. The young mother does not hesitate to enrol  her  infant  in  the  vaccine  trial programme when the official suggests it to her.

The centre was named after Dr. George Joaki  who  worked  at  the  UNC  project and greatly contributed to the cause of malaria  eradication.  He  died  on  18th October, 2007 in a tragic car accident. On  the  left  side  on  the  centre,  just before  the  entrance,  a  stone  plague reads  "in  memory  of  our  beloved colleague  Dr.  George  Joaki.  24th November 1969- 18th October, 2007.

F u n d e d   b y   B i l l   M e l i n d a   G a t e s   Foundation  under  the  Programme  for Appropriate  Health  Technology  - Malaria Vaccine Initiative (PATH-MVI), the structure cost K28 million and will have the largest trials in Africa, beating Kenya,  Ghana,  Gabon,,  Burkina  Faso, Tanzania, Mozambique and Mali. It will bring the total number of trial sites to 11 in seven African countries.

Community sensitisation is one of the preparatory  activities  of  the  trial  by UNC, to be  held at George Joaki centre. UNC  is  implementing  the  trials  in collaboration  with  the  Ministry  of Health  (MoH).  The  project  has  also established  clinical  sensitisation  at KCH  and  health  centres  in  Lilongwe and  is  in  constant  interaction  with chiefs, political leaders and Traditional Birth Attendants (TBAs).

UNC  Project  Administration  Manger, Innocent  Mofolo  told  a  group  of journalists that visited the site as part of  this  year's  World  Malaria  Day  on 25th  April  that  permission  for participation  was  sought  using ethically  accepted  standards.  He  did not elaborate.

Consultations  for  constructing  the centre started in April last year and it has  a  reception  area,  consultation room,  conference  room,  a  room furnished  with  four  baby  cots  and  a data processing room that is yet to be fitted  with  eight  laptops  to   allow  for information  transmission  directly  to Belgium,  headquarters.  It  will  have  a lab, specific for malaria.

He said about US$12 billion is spent in Africa for the treatment of malaria and that  money  spent  in  its  prevention would  be  a  small  price  to  pay.  He however did not have the actual figure of how much the trials would cost.

Mofolo  said  George  Joaki  centre  will work  in  close  collaboration  with  UNC Tidziwe  Malaria  Research  site  at  KCH which  already  has  a  pharmacy  and l a b o ra t o r y   a l re a dy   a t   w o r k   i n preparation  for  the  trials.  It  also  has two  satellite  dishes  to  enhance communication between sites.

Tidziwe,  a  vernacular  name  meaning "we should find out" is housed in a two- storey,  17,500  sq  ft  building  within KCH  premises.  It  has  an  outpatient research  exam,  counselling  rooms,  a state of the art laboratory and medica library with satellite web connections supporting journal access.

It has a lecture hall and classroom with teleconferencing  capacity,  a  data management  area  with  remote  and local  data  entry  capacity,  secure  data The  centre  has  a  storage  space,  a p h a r m a c y   a n d   d i s p e n s a r y administrative and community activity office space.  

UNC Project employs over 250 people  in  Malawi  consisting  of  medical  and clinical officers, nurses, laboratory and pharmacy  technicians,  data  officers and  administrative   and  logistical support staff.

  
L a b o r a t o r y   C o n s u l t a n t   D e b b i e Kamwendo, said the lab at Tidziwe was internationally  accredited  and  one  of four in Lilongwe. It contains full blood c o u n t   m a c h i n e s ;   C D 4   c o u n t i n g machines  blood  chemistry  analysers, c o n d u c t s   h a e m a t o l o g y   a n d microbiology. She also said that the lab  was computerised and the best in the country  which  was  also  used  as referral  lab  for  other  diseases  like meningitis  and  HIV/Aids  among others.

R T S S   M a l a r i a   V a c c i n e s   S t u d y Coordinator  for  the  UNC  project Tisungane  Mvalo  said  the  third  phase for  the  vaccine  trial  would  be  the  last  stage  before  it  is  either  approved  for licensing or rejected, which he said was a  positive  sign  towards  malaria eradication. He explained that the last two phases proved successful in terms of safety and effectiveness.

Once  fully  complete,  Mvalo  said  trials would begin but neither he nor Mofolo c o u l d   g i v e   s p e c i f i c   d a t e s   f o r commencement .  Meanwhile,  the country eagerly waits to join the world in bidding malaria goodbye.