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Nekoye Otsyula standing in front of a stone wall.

Malaria researcher Dr. Nekoye Otsyula is working toward the day when the disease is a distant memory. Photo: PATH/Eric Becker.

Dr. Nekoye Otsyula is committed to beating the disease that nearly killed her daughter

The terrible irony was not lost on Dr. Nekoye Otsyula as she sat beside her two-year-old daughter’s hospital bed: a veteran malaria researcher’s daughter had been struck down by malaria.

For four harrowing days, Nekoye watched her daughter struggle to bounce back from the life-threatening illness. And she felt her professional commitment to malaria research harden into a personal passion to eliminate the disease.

“Seeing your child, who was previously active and playing, now unable to move…You stop looking at malaria as a researcher,” she says. “You look at it now as a mom.”

Progress toward a vaccine

Nekoye has worked alongside other scientists at the KEMRI/Walter Reed Project’s Kombewa Clinical Research Center on trials of the most clinically advanced malaria vaccine candidate. Support for the vaccine candidate, called RTS,S, has come from the PATH Malaria Vaccine Initiative, together with partner GlaxoSmithKline Vaccines and scientists at 11 trial sites in seven African countries.

As a staff physician, Nekoye provides medical care for children in the trials. As a sub-investigator and research officer, she is involved in two studies of the vaccine candidate—a large trial to determine the efficacy of the vaccine and a smaller trial with children who are HIV positive.

The pivotal phase 3 efficacy trial was designed to provide data about RTS,S in different malaria parasite transmission settings and different age groups, as well as information on the impact of a booster dose. The results help the World Health Organization develop policy recommendations, paving the way for African nations to decide whether to use the vaccine as part of their immunization programs.

Kenya’s malaria capital

Nekoye calls the area where she lives and works in western Kenya the country’s “malaria capital,” where the disease is a leading cause of death for children under age five. Malaria is so common in the communities that ring Lake Victoria that many people are resigned to the disease and may not seek treatment until it’s too late.

If the vaccine trial is successful, Nekoye is hopeful that a malaria vaccine will be a powerful addition to the tools available to fight malaria, including insecticide-treated bednets, proper treatment, and accurate diagnosis.

“If you have all those [tools] working together, it means more children can be in school every day. It means more mothers…and more fathers can be working to raise money for their families,” she says.

Taking malaria personally

Nekoye, a 2005 graduate of the University of Nairobi medical school, suffered from malaria as both a child and an adult. But when her daughter got sick, Nekoye’s perspective on malaria changed.

Her daughter came down with a fever and vomiting suddenly one night and by the next day had grown listless and unresponsive. Nekoye rushed her to a pediatrician, who admitted her to the hospital with malaria. Over the next four days, the girl slowly improved until she completely recovered.

Nearly losing her daughter to the disease has deepened Nekoye’s understanding of malaria’s toll on families and children. “It gives me passion and spirit and strength to work on this trial,” she says. “And then we can move on and deal with other diseases.”

Toasting the end of malaria

Malaria’s toll is measured not just in lives lost, but also in lost income, lost economic opportunity, and lost learning time. Nekoye sees a malaria vaccine as a key step toward improving Kenya’s overall health and economic prospects.

“I look forward to the day when we can toast the prospect of reduced maternal and childhood deaths, improved school attendance, improved chances that children can go to college or learn a trade, and improved social and economic status,” she says—a day when malaria no longer drains Kenya’s resources and devastates families.