mechanisms and antigens, malaria vaccine development can be used as a model for testing new vaccine technologies that should be of interest to industrial partners.

Work with malaria vaccines has broadly advanced the field of vaccinology, although it has thus far failed to identify a successful vaccine against malaria itself. The first Escherichia coli–produced recombinant protein vaccine ever tested in humans was a malaria vaccine. The first synthetic peptide carrier conjugate vaccine tested in humans was also a malaria vaccine. The first assessment of DETOX (monophosphoryl lipid A and cell wall skeleton of mycobacteria) as an adjuvant for a vaccine against an infectious agent was made with malaria antigens. The first successful use of liposomes with monophosphoryl lipid A as a delivery system (adjuvant) in humans was in a malaria vaccine, and several new adjuvant formulations are now being tested in humans. The first multivalent recombinant vaccinia tested in humans was a malaria vaccine, and an early recombinant S. typhi vaccine tested in humans was a malaria vaccine.

While no one can predict what a final successful malaria vaccine will be, workshop participants generally agreed that the elements for scientific success are moving into place. What is most needed now is a focused, systematic, and multisectoral approach to vaccine development that, as a first step, identifies the scientific hurdles remaining and the funds that will be required to overcome them. In the absence of an established, coordinated strategy, however, such assessments will have little validity and will understandably lack credibility.

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