[우리도 사람을 살릴 수 있다면] Mosquito’s Counterattack

Hyeongjun Kim, Senior Manager, GAVI (Global Alliance for Vaccines and Immunization)

“A shark appeared!”

We often hear news about sharks appearing in the sea off our coasts every year. All attention is focused, perhaps due to the fear that a shark bite could result in death. But would you believe it if an animal claimed more lives every day than sharks have killed around the world over the past 100 years (about 1,000)? This is the story of today’s protagonist, a mosquito.

Mosquitoes, which are commonly seen around us, spread more diseases around the world than we think. Malaria and Japanese encephalitis, as well as dengue fever and yellow fever, which are not familiar to us, are representative diseases transmitted by mosquitoes. In fact, malaria alone kills 600,000 people every year, most of them children under the age of five. Simply put, more children die from mosquitoes every year than the total number of Korean soldiers. Most of these tragedies occur in sub-Saharan Africa.

The threat that mosquitoes pose to human health is not a new story. There are records of mosquito-borne diseases believed to be malaria in ancient Egypt and Mesopotamia, and it is known that many people died from malaria and yellow fever in Africa even during Europe’s colonial expansion in Africa. But now we are facing a new phase in the fight against mosquitoes. At the center are climate change and vaccines.

◇ Climate change and mosquitoes

The Earth, which has become warmer due to climate change, has become a better environment for mosquitoes to spread diseases. A recent study found that due to climate change, mosquitoes that spread malaria are moving to higher altitudes by an average of 6.5 meters each year, and are expanding by 4.7 kilometers from the equator. As a result, regions that are underprepared for malaria are also at risk, and more people are exposed to mosquito-borne diseases.

In addition, studies have shown that due to climate change, malaria-carrying mosquitoes reproduce faster, bite more often, and expand their range into habitats they did not live in before. The process of mosquitoes metamorphosing from larvae to adults generally takes place at temperatures between 22 and 34 degrees Celsius, but climate change has made it possible for mosquitoes to be active even in the fall and winter. Mosquito behavioral patterns and habitat changes are evolving in ways that threaten human life. This is a ‘mosquito counterattack’ in which man-made climate change changes the way mosquitoes survive and these mosquitoes return to humans and spread diseases.

◇ Malaria vaccine development and introduction

There is good news even during the counterattack. A vaccine that can prevent malaria has been developed. Malaria vaccine development, which began in the 1960s, has recently made great progress. In the past two years, two types of vaccines have been approved by the World Health Organization (WHO) and supplied to the market. The RTS,S vaccine was launched in 2022, and the R21/Matrix-M vaccine went through all processes last year to verify safety and efficacy and began being administered to African countries. Starting with the supply of 330,000 doses of vaccine to Cameroon last November, malaria vaccines are scheduled to be introduced to about 20 African countries by 2024.

Malaria vaccination site. /GAVI

Of course, this vaccine is not provided for free. Developed countries such as Korea provide financial support to international organizations such as the Global Alliance for Vaccines and Immunization (GAVI) to help purchase vaccines. GAVI is negotiating with pharmaceutical companies to lower vaccine prices and prioritize supply to areas with high malaria incidence. The Bill Gates Foundation also sponsored initial research and clinical trials in cooperation with academia, pharmaceutical companies, and NGOs, and played an important role in ensuring that the developed vaccine was released to the market at an appropriate price.

So, can the malaria vaccine prevent mosquitoes from attacking? As a result of introducing the vaccine in the field, it is said that the child mortality rate was reduced by about 13% through the malaria vaccine, and that the preventive effect reached up to 77% when administered during a time when malaria incidence was high. This may not seem like a large number, but it means that about 23,000 children will not have to die from malaria every year. If we can save the life of one child, and if that child is our neighbor, 23,000 seeds of hope will be sown.

Côte d’Ivoire children smiling under mosquito nets. /UNICEF

However, this does not mean that children dying from malaria completely disappear. This is because there are not many ways to avoid mosquitoes. If children under the age of five in Africa do not sleep under mosquito nets, if mosquito breeding conditions around their homes are not improved, if diagnostic kits are not available for rapid testing, or if health services are not functioning properly to provide treatment, we will still lose many lives. will lose So while the news of the vaccine is welcome, our fight is still ongoing.

◇ all of us

The fight against malaria is not just a problem for African children. It’s our problem too. Last July, a malaria alert was issued for the first time in Seoul. Malaria-carrying mosquitoes, which were mainly found only in the northern Gyeonggi or Gangwon regions, have arrived in Seoul. Many people may think of a vaccine, but the current malaria vaccine is a vaccine that prevents ‘tropical falciparum’ malaria that occurs in Africa, so it is not effective against ‘Samil fever’ malaria that occurs in Korea. Fortunately, we have a great medical system, so if you catch it at the right time, you can receive appropriate treatment. So you don’t need to worry too much. However, I hope that we have the empathy to listen to their pain.

Hyeongjun Kim, Senior Manager, GAVI (Global Alliance for Vaccines and Immunization)

I am currently enrolled in a doctoral program at Harvard University Graduate School of Public Health. Previously, I worked at the international organization UNICEF for about 10 years, working to promote healthy lives for children and adolescents in developing countries in Nepal, Ghana, Malaysia, and Afghanistan. At the same time, I am working as a senior manager at the Global Alliance for Vaccines and Immunization (Gavi), continuing the mission to save children in underdeveloped countries through vaccines. While working as a health communication expert in a developing country, I have experienced various ways to save people by preventing diseases, and I would like to share this with many people.