Every week I check the news in the malaria world to see if there is anything of interest. This week there was a press release from the WHO announcing the Shipment of newest malaria vaccine, R21, to Central African Republic  and claiming it marks latest milestone for child survival. Needless to say I was intrigued because when I completed my recent book, Malaria is spread by mosquitos? such evidence was not available.

I contacted the WHO, GAVI and UNICEF email addresses on the press release and WHO were good enough to respond. I was provided with a reference to a Lancet article Safety and efficacy of malaria vaccine candidate R21/Matrix-M in African children: a multicentre, double-blind, randomised, phase 3 trial by Datoo et al. of the  Centre for Clinical Vaccinology and Tropical Medicine, The Jenner Institute, University of Oxford and the NIHR Oxford Biomedical Research Centre, Oxford, UK.

I was very surprised to find out in the first few lines of the paper that it was a double-blind randomised study and the control group received an Indian rabies vaccine called Abhayrab. Listed on the netmeds website are the following side effects, and a lot more on the topic.

SIDE EFFECTS OF ABHAYRAB PF VACCINE

COMMON

• Headache, dizziness
• Rash, hives
• General discomfort
• Fatigue, weakness
• Fever
• Swollen glands
• Decreased appetite
• Nausea, vomiting, diarrhoea, stomach pain
• Muscle pain, joint pain
• Pain, redness, swelling, itching or bruising at the site of injection
• Hardness of the skin at the site of injection

RARE

• Tingling sensations
• Sweating, chills

Stop receiving ABHAYRAB PF VACCINE and contact your doctor if you experience any of the following side effects:   Signs of anaphylactic reactions (serious allergic reactions) such as shock (severe drop of blood pressure), itching, skin rash, swelling of face and/or neck, breathing difficulties, bluish discoloration of the tongue or lips, low blood pressure, rapid heart rate, weak pulse, skin coldness, dizziness and fainting

From  April 26, 2021, to Jan 12, 2022, researchers from Oxford poisoned 5477 children in Burkina Faso with R21 or Abhayrab. Why is one supposed to take such a study seriously? R21 is marginally less toxic than a toxic vaccine against rabies, another dubious disease.

I visited Africa for the first time this winter. It was great to leave dreary wet Northern Europe to enjoy the sun vertically overhead near the Tropic of Capricorn in December. What was also pleasant was the optimism of the people and the feeling that Africa is developing quickly and the living standards of the people could soon catch up with the west.

Nearly everyone has a smart phone and the 4G coverage is good. One of the first things I did was get a local SIM to avoid roaming charges. The cars were the same as in West – mostly Japanese and typical western brands. The roads around the capital city of Botswana, Gabarone, are mostly well built. There are many new flyovers recently built by Chinese construction companies.

I was struck by a feeling that Africa has a future. I see similarities with the Ireland of 1970s in which I grew up. There are many small children. The continent is vast with much space to accommodate a rising population. There is much mineral wealth. There is a great climate for growing food and cash crops.

There are three major issues to be tackled to allow Africa to flourish – Energy, Water and governance.

While it needs much improvement, of the three we should be less worried about governance. Historically, much of Africa was ruled by colonial masters whose modus operandi was to divide and conquer the local peoples. This legacy continues with the borders of nation states typically the same as the colonial boundaries. Countries with less tribal division like Botswana do not suffer from the same issues. As the people’s expectations increase their tolerance of poor governance will decline and they will find ways to live peacefully and productively.

Availability of clean water is a major issue. Africa is the second driest continent with 9% of worlds fresh water for 16% of world population. Despite this relative lack of water, with good management there is sufficient water for drinking, agriculture and industrial needs.

Water is not evenly distributed geographically and rainfall is typically seasonal. Water distribution infrastructure is not well developed in many places.

For future economic developments in industry and agriculture more water is needed. To meet this need more infrastructure is required. More reservoirs, pipelines and associated purification facilities are needed. Many projects will cross borders.

These projects are feasible. With organisation and support there is no reason why water scarcity will continue to be an issue except in the most arid and sparsely populated areas.

Energy is not as available or reliable as elsewhere in the world. There is a deficiency of electricity infrastructure and a shortage of bottled hydrocarbon fuels for cooking, etc. In many places people have no options other than burning dung or timber to cook and heat. This results in poor internal air quality which contributes to respiratory illnesses and felling of many trees which causes environmental harm.

Africa is rich in minerals including carbon fuels. It has many great rivers not yet harnessed for hydroelectricity. With investment it should be possible to develop the fuel supply and build power power stations and a distribution network. Unfortunately, for Africa it has been affected by the climate catastrophe issue that dominates western politics. Despite much evidence that the effects of CO₂ have been greatly exaggerated and investment in carbon based fuels causes many more benefits than harms, the world bank and other western sources of finance pander to the loud activists. They are reluctant to support investment for carbon fuelled energy in Africa. Unless there is a major change these projects will be supported instead by China and India. The people will demand proper electricity and their leaders will do what it takes to get it.

I recently made a presentation to a delegation developing a major carbon fuel infrastructure project in Africa about how unrealistic it is to expect to make such investments and comply with the climate change commitments made at the Paris climate conference.

Africa has a great future. Power and water infrastructure development will help it happen.