The World Health Organization, WHO, has confirmed that 331,200 doses of the first approved malaria vaccine by—RTS, S—have been received in Yaounde, Cameroon.
The first delivery of the vaccine to a nation not previously a part of the malaria vaccine pilot programme suggests that the highest-risk regions of the African continent may soon see a roll-out of the vaccine.
A further 1.7 million doses of the RTS, S vaccine are expected to arrive in Burkina Faso, Liberia, Niger and Sierra Leone in the coming weeks, with additional African countries set to receive doses in the months ahead.
The WHO says this reflects the fact that malaria vaccination is moving out of its pilot phase for malaria vaccine introduction into routine immunisation programmes, which should see the first doses administered in the first quarter of 2024.
Nigeria has not yet been included in the rollout of the RTS, S malaria vaccine, and is still waiting for approval from the WHO Strategic Advisory Group of Experts (SAGE) on Immunization is currently reviewing the vaccine’s safety and efficacy data.
Nearly every minute, a child under five dies of malaria. In 2021, there were 247 million malaria cases globally, which led to 619,000 deaths.
Of these deaths, 77 per cent were children under 5 years of age, mostly in Africa. The malaria burden is the highest on the African continent, which accounts for approximately 95 per cent of global malaria cases and 96 per cent of related deaths in 2021.
Since 2019, Ghana, Kenya, and Malawi have been administering the vaccine in a schedule of 4 doses from around 5 months of age in selected districts as part of the pilot programme, known as the Malaria Vaccine Implementation Programme (MVIP).
More than two million children have been reached with the malaria vaccine in three African countries through MVIP – resulting in a remarkable 13 per cent drop in all-cause mortality in children age eligible to receive the vaccine and substantial reductions in severe malaria illness and hospitalizations.
Other key findings from the pilot programme show that vaccine uptake is high, with no reduction in the use of other malaria prevention measures or uptake of other vaccines. MVIP is coordinated by WHO in collaboration with UNICEF and other partners, and funded by Gavi, the Global Fund, and UNITAID, with donated doses from GSK, the manufacturer of the RTS, S vaccine.
The data from the pilot have shown the impact and safety of the RTS, S vaccine and provided important evidence on vaccine acceptability and uptake that helped inform the recent WHO recommendation of a second malaria vaccine – R21, manufactured by the Serum Institute of India (SII).
Results of a phase 3 trial for R21 showed that the vaccine has a good safety profile in the clinical trial setting and reduces malaria in children. It is expected that, like RTS, S, when R21 is implemented it will have a similar high public health impact. The choice of which vaccine to use in a country should be based on programmatic characteristics, vaccine supply, and affordability.
The R21 vaccine is currently under review by WHO for prequalification. The availability of two malaria vaccines is expected to increase supply to meet the high demand from African countries and result in sufficient vaccine doses to benefit all children living in areas where malaria is a public health risk.
In preparation for scaled-up vaccination, Gavi, WHO, UNICEF, and partners are working with countries that have expressed interest and/or have confirmed rollout plans on the next steps.
These developments mean that broad implementation of malaria vaccination in endemic regions has the potential to be a game-changer for malaria control efforts, and could save tens of thousands of lives each year.
The CEO of Gavi, the Vaccine Alliance, David Marlow, said, “The world needs good news – and this a good news story. Gavi is proud that our Alliance of stakeholders, with African countries at the forefront, took the decision to invest in the malaria vaccine as a public health priority, and that this support has played a part in the availability of a new tool that can save the lives of thousands of children each year.
“We are excited to roll out this historic vaccine through Gavi programmes and work with partners to ensure it is delivered alongside other vital measures.”
The UNICEF Executive Director, Catherine Russell, noted, “This could be a real game-changer in our fight against malaria. Introducing vaccines is like adding a star player to the pitch.
“With this long-anticipated step, spearheaded by African leaders, we are entering a new era in immunization and malaria control, hopefully saving the lives of hundreds of thousands of children every year.”
On his part, WHO Director-General, Dr Tedros Adhanom Ghebreyesusremarked, “This is another breakthrough moment for malaria vaccines and malaria control and a ray of light in a dark time for so many vulnerable children in the world.
“The delivery of malaria vaccines to new countries across Africa will offer life-saving protection to millions of children at risk of malaria. But we must not stop here. Together, we must find the will and the resources to bring malaria vaccines to scale, so more children can live longer, healthier lives.”
Also speaking, the WHO Regional Director for Africa, Dr Matshidiso Moeti, observed, “This is a significant advancement towards scaling up malaria vaccination in the region. The vaccine, which protects children from the severe forms of the disease, is a vital addition to the existing set of malaria prevention tools and will help bolster our efforts to reverse the rising trend in cases and further reduce deaths.”
Executive Director of the Global Fund, Peter Sands, noted, “Today’s announcement is welcome news given that malaria remains a primary cause of childhood illness and death in sub-Saharan Africa. Using this vaccine, appropriately prioritized in the context of existing tools, could help prevent malaria and save tens of thousands of young lives each year.”
“I am thrilled that the RTS, S vaccine, which is the result of so many years of work by PATH, GSK, and African partners, has arrived in Cameroon and will soon reach even more children at risk of malaria,” said Nikolaj Gilbert, President and CEO of PATH. “All of us at PATH appreciate the efforts by Gavi, UNICEF, and WHO to accelerate access to this life-saving vaccine.”
Source: Vanguard