Malaria fighter: this researcher paved the way for a game-changing vaccine 疟疾斗士：这位研究者为改变游戏规则的疫苗铺平了道路

This story is part of Nature’s 10, an annual list compiled by Nature’s editors exploring key developments in science and the individuals who contributed to them.
这个故事是《自然》杂志年度十大科学进展名单的一部分,该名单由《自然》杂志的编辑们编制,旨在探索科学领域的关键发展及其贡献者。

In October, work and life collided for Halidou Tinto when his six-year-old daughter caught malaria. A director of clinical trials for malaria drugs and vaccines for more than a decade, Tinto knew how severe the disease could be. His daughter was hospitalized for four days with a fever, headaches and vomiting. She recovered, but “it was really serious”, he says.
在十月份,哈利杜·廷托的工作和生活发生了冲突,因为他六岁的女儿感染了疟疾。作为一名从事疟疾药物和疫苗临床试验的负责人超过十年,廷托知道这种疾病可能有多么严重。他的女儿因为发烧、头痛和呕吐住院四天。她恢复了,但他说:“这真的很严重。”

That same month, a vaccine called R21 that he had been testing was recommended for use by the World Health Organization (WHO). It is only the second malaria vaccine to be approved and many think it could prevent millions of deaths in Africa, where the vast majority of malaria infections occur. Every year there are more than 200 million cases and 500,000 deaths on the continent, predominantly in children younger than 5 years old.
同月,他一直在测试的一种名为R21的疫苗被世界卫生组织(WHO)推荐使用。这是仅有的第二种获批的疟疾疫苗,许多人认为它可以预防非洲数百万人的死亡,在那里发生了绝大多数的疟疾感染。非洲每年有超过2亿例疟疾病例和50万死亡病例,主要是5岁以下的儿童。

The institute that Tinto directs, the Clinical Research Unit of Nanoro (CRUN) in Burkina Faso, is a key test site for R21, its predecessor RTS,S and several other drugs. Many scientists credit Tinto’s diligence for the institute’s success.
廷托所领导的机构,位于布基纳法索的纳诺罗临床研究单位(CRUN),是R21及其前身RTS,S和其他几种药物的关键测试场所。许多科学家认为,正是廷托的勤奋使得该研究所取得了成功。

Tinto earned a PhD at the University of Antwerp in Belgium, studying how malaria becomes resistant to various drugs. His adviser at the time, Umberto D’Alessandro, a clinical epidemiologist now at the London School of Hygiene & Tropical Medicine and based in Fajara, the Gambia, says that he has always been struck by both Tinto’s rigour as a scientist and his dedication. “He truly wants to advance science and research in Africa,” says D’Alessandro.
廷托在比利时安特卫普大学获得了博士学位,研究疟疾如何对各种药物产生抗药性。当时的导师乌贝托·达莱桑德罗,现为伦敦卫生与热带医学院的临床流行病学家,常驻冈比亚的法加拉,他说他一直对廷托作为科学家的严谨性和他的奉献精神印象深刻。达莱桑德罗说:“他真的想推动非洲的科学和研究。”

Tinto had an opportunity to do a postdoc at a US university, but turned it down to return to Burkina Faso in 2006. There, he helped to establish the CRUN with local scientists and clinicians.
廷托有机会在一所美国大学做博士后研究,但他在2006年拒绝了,选择回到布基纳法索。在那里,他与当地科学家和临床医生一起帮助建立了CRUN。

In 2007, pharmaceutical company GSK and its partners were gearing up to do late-stage clinical trials of RTS,S — a vaccine that had been in development for years. For Tinto’s new clinic, with just ten employees, becoming part of the trial seemed like a long shot. “They were surprised that we applied,” he says, “because there was no electricity, no cars, nothing.” Nevertheless, Tinto convinced the coordinators that he could make it work.
2007年,制药公司GSK及其合作伙伴正准备进行RTS,S疫苗的后期临床试验,这种疫苗已经研发多年。对于Tinto新诊所来说,仅有十名员工,成为试验的一部分似乎是个遥不可及的目标。他说:“他们对我们的申请感到惊讶,因为这里既没有电力,也没有汽车,什么都没有。”尽管如此,Tinto还是说服了协调员,他能够让一切正常运作。

He met with the king of the village, and together they persuaded the Burkina Faso government to connect Nanoro to the national grid. The CRUN produced data that helped to get RTS,S approved in Africa.
他与村庄的国王会面,他们一起说服了布基纳法索政府将纳诺罗接入国家电网。CRUN产生的数据帮助RTS,S在非洲获得批准。

That vaccine has been associated with a significant reduction in child mortality. But GSK can produce only a few million doses a year. Even if Burkina Faso got one million of those, Tinto says, that would vaccinate only 250,000 children a year. “We still have millions of children lagging behind,” he says. That’s why people are excited about R21: the Serum Institute of India in Pune can currently produce 100 million doses a year. R21 should also be more affordable than RTS,S, and some researchers expect it to be more effective.
这种疫苗与儿童死亡率的显著降低有关。但是葛兰素史克每年只能生产几百万剂。即使布基纳法索得到了其中的一百万剂,廷托说,这每年也只能为25万儿童接种。“我们仍然有数百万儿童落后,”他说。这就是人们对R21感到兴奋的原因:印度普纳的血清研究所目前每年可以生产1亿剂。R21预计也会比RTS,S更实惠,一些研究人员期望它会更有效。

Tinto ran an influential early study of the vaccine, starting in 2019 (M. S. Datoo et al. Lancet 397, 1809–1818; 2021). “He led the trial that really, to people in the field, showed that this vaccine was going to be different,” says Adrian Hill, a vaccinologist at the University of Oxford, UK, who oversaw the development of R21.
廷托在2019年开始了一项有影响力的疫苗早期研究(M. S. Datoo等人,《柳叶刀》杂志,397卷,第1809-1818页;2021年)。英国牛津大学疫苗学家阿德里安·希尔说:“他领导的试验真的向该领域的人们展示了这种疫苗将会有所不同。”希尔监督了R21疫苗的开发。

The WHO has said that R21 will be available across Africa as early as mid-2024. Meanwhile, Tinto is working on more than 30 clinical trials, including two further malaria vaccines and more studies on R21.
世界卫生组织表示,R21疫苗最早将于2024年中期在非洲各地推广。与此同时,廷托正在进行30多项临床试验,包括另外两种疟疾疫苗和更多关于R21的研究。

CRUN has expanded beyond Nanoro, and now has more than 400 staff members and associates, including dozens of graduate students from all over Africa. D’Alessandro, with whom Tinto still collaborates, says that it is a good example of how research can stimulate development in Africa. But what inspires Tinto the most is the opportunity to save lives. “You cannot have really any other satisfaction beyond that; because life, for me, is the most important thing.”
CRUN已经扩展到纳诺罗以外的地区,现在拥有400多名员工和合作伙伴,包括来自非洲各地的数十名研究生。与廷托仍在合作的达莱桑德罗表示,这是研究如何刺激非洲发展的一个很好的例子。但是激励廷托最多的是拯救生命的机会。“因为对我来说,生命是最重要的,除此之外你真的无法获得任何其他满足感。”