The World Health Organisation (WHO) approval for a vaccine against malaria offers a glimmer of hope for the African continent, which shoulders the heaviest burden of the disease that kills thousands, mostly children, every year.
The WHO recently recommended widespread use of ‘RTS, S’ or Mosquirix malaria vaccine developed by a British drugmaker among children in sub-Saharan Africa and in other regions with moderate to high P. falciparum malaria transmission.
The recommendation is based on results from a WHO-co-ordinated large-scale ongoing pilot programme in Ghana, Kenya and Malawi. Since 2019, some 2.3mn doses of Mosquirix have been administered to infants in these countries.
Malaria remains a primary cause of childhood illness and death in sub-Saharan Africa. More than 260,000 African children under the age of five die from malaria annually.
Malaria is far more deadly than Covid-19 in Africa, according to Reuters. It killed 386,000 Africans in 2019, according to a WHO estimate, compared with 212,000 confirmed Covid-19 deaths in the past 18 months.
The WHO says 94% of global malaria cases and deaths occur in Africa, a continent of 1.3bn people. The preventable disease is caused by parasites transmitted to people by the bites of infected mosquitoes. Symptoms include fever, vomiting and fatigue.
The vaccine’s effectiveness at preventing severe cases of malaria in children is only around 30%, but it is the only approved vaccine. The European Union’s drugs regulator approved it in 2015, saying its benefits outweighed the risks.
In recent years, WHO and its partners have been reporting a stagnation in progress against the deadly disease.
Financing for the pilot programme was mobilised through an unprecedented collaboration among three key global health funding bodies: Gavi, the Vaccine Alliance; the Global Fund to Fight AIDS, Tuberculosis and Malaria; and Unitaid.
“This is a historic moment. The long-awaited malaria vaccine for children is a breakthrough for science, child health and malaria control,” said WHO Director-General Dr Tedros Adhanom Ghebreyesus.
“Using this vaccine on top of existing tools to prevent malaria could save tens of thousands of young lives each year,” Ghebreyesus noted.
A global market study led by the WHO this year projected demand for a malaria vaccine would be 50 to 110mn doses per year by 2030 if it is deployed in areas with moderate to high transmission of the disease.
Next steps for the WHO-recommended malaria vaccine will include funding decisions from the global health community for broader rollout, and country decision-making on whether to adopt the vaccine as part of national malaria control strategies.
The Gavi vaccine alliance, a global public-private partnership, will consider in December whether and how to finance the vaccination programme.
Experts said mobilising funds for production and distribution of the vaccine to some of the world’s poorest countries still remains a major challenge.
“As we have seen from the Covid vaccine, where there is political will, there is funding available to ensure that vaccines are scaled to the level they are needed,” said Kate O’Brien, director, WHO’s Department of Immunisation, Vaccines and Biologicals.
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