CAPE TOWN - Healthcare professionals have hailed the long-awaited World Health Organisation (WHO) recommended malaria vaccine for children as a historical breakthrough for science, child health and malaria control across the continent.
Malaria remains a primary cause of childhood illness and death in sub-Saharan Africa and more than 260 000 African children die from malaria annually - most under the age of five.
The WHO this week announced they were recommending the widespread use of the RTS,S/AS01 (RTS,S) malaria vaccine among children in sub-Saharan Africa and in other regions with moderate to high P. falciparum malaria transmission.
The vaccine was proven effective six years ago, preventing 40% of malaria cases and 30% of severe cases.
Since 2019, researchers have been carrying out wider pilot immunisation programmes in Ghana, Kenya and Malawi.
For centuries, malaria has stalked sub-Saharan Africa, causing immense personal suffering, said WHO regional director for Africa, Dr Matshidiso Moeti.
“We have long hoped for an effective malaria vaccine and now for the first time ever we have such a vaccine recommended for widespread use. Today’s recommendation offers a glimmer of hope for the continent which shoulders the heaviest burden of the disease and we expect many more African children to be protected from malaria and grow into healthy adults,” Moeti said.
Senior lecturer from the Department of Global Health at Stellenbosch University, Dr Jo Barnes, said Malaria is a parasite that is carried by mosquitoes.
“When the mosquitoes bite, the parasite invades the body and destroys the blood cells in order to reproduce. There are drug treatments available once a person is infected and bed-nets are used to prevent bites.
“Insecticides are used to kill the mosquito. These measures have all helped reduce the incidence of malaria. Africa is the continent worst affected by malaria (94% of cases occur in Africa) and the worst affected age group is children. In Africa more than 260 000 children died from the disease in 2019. This is a heavy burden of disease and loss of life,” Barnes said.
International medical humanitarian organisation Doctors Without Borders (MSF) said despite the low efficacy of the vaccine, its impact can be considerable, given the high burden in areas where children can get malaria several times a year.
However, the organisation said they still have some concerns.
“It is expensive [around 5-7 USD a dose (about R100) to be confirmed] and the cold chain is very demanding. Considering large scale vaccination activities will be needed to have a significant impact, means the overall cost of using the vaccine will be very high, and probably too high for many of the places where it is most needed. It is crucial to ensure that the introduction of the vaccine doesn’t go at the expense of other essential malaria measures, or divert resources from routine vaccination programmes.
“Further evidence is required on using this vaccine in specific humanitarian settings (such as camps of displaced population/migrants, high insecurity contexts, or remote and hard to reach areas), in addition to further research on alternate malaria vaccines,” MSF said.
The 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 organisation said financing for the pilot programme has been mobilised through an unprecedented collaboration among global health funding bodies: Gavi, the Vaccine Alliance; the Global Fund to Fight Aids, Tuberculosis and Malaria; and Unitaid.
The fight against malaria had stalled in 2019 according to WHO, but using the vaccine as an additional tool against the disease “could save tens of thousands of lives of children each year”.