The World Health Organization (WHO) is recommending widespread
use of the world’s first malaria vaccine, in
what the UN health agency’s chief described on Wednesday as
“an historic day” for the decades-long battle against the deadly
disease.
The vaccine is geared towards children, in sub-Saharan
Africa and other regions with moderate to high
transmission.
The recommendation to begin using
the RTS,S vaccine, is based an ongoing
pilot programme set up by WHO and
partners in Ghana, Kenya and Malawi, that has reached
more than 800,000 children since 2019.
“The long-awaited malaria vaccine for children is a breakthrough
for science, child health and malaria control”, said
the WHO Director-General,
Tedros Adhanom Ghebreyesus. “Using this vaccine on top of
existing tools to prevent malaria could save tens of thousands of
young lives each year.”
Stagnation in progress
Tedros said the world had made “incredible
progress” in the fight against malaria in the past two
decades.
The malaria parasite is mostly transmitted
by infective mosquitoes and carried in the blood, after
being bitten. It is not contagious person-to-person,
and symptoms include a fever of flu-like illness, nausea and
vomiting, and if left untreated, it can be fatal,
killing more than 400,000 each year worldwide.
Since 2000, deaths have fallen by more than half, and the
disease has been eliminated in many parts of the
world.
For the WHO chief, though, progress has stalled at
an unacceptably high level, with more than 200 million
cases still occurring each year. Two-thirds of those who die
from
the disease, are children under five in
Africa.
Childhoods decimated
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.
WHO Regional Director for
Africa, Matshidiso Moeti, said that "for
centuries, malaria has stalked sub-Saharan Africa, causing
immense personal suffering.”
“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”, she said.
For Ms. Moeti, 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.”
Recommendations
Based on the advice of two WHO global advisory bodies, one for
immunization and the other for malaria, the UN
Agency has made a series
of specific recommendations.
The immunization should be administered in regions with
moderate to high transmission, in a schedule
of four doses, in children
from five months of age and up.
According to Tedros, the pilot study has shown that the
vaccine can be easily delivered through child health clinics by
Ministries of Health, reaching children with high coverage. There
is strong community demand, and
it has “broad reach to children, including the most
vulnerable who may not use a bednet” to keep out
mosquitoes, and it is highly cost-effective.
Deaths reduced by a third
To date, more than 2.3 million doses of the vaccine have been
administered, showing a favorable safety
profile.
The vaccine showed a significant reduction (30%) in deadly severe
malaria, even when introduced in areas where insecticide-treated
nets are widely used and there is good access to diagnosis and
treatment.
The study showed that the distribution of the vaccine had
no negative impact on uptake of bednets, other
childhood vaccinations, or health-seeking behavior for other
febrile illness.
The next steps 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.
“This is a powerful new tool, but like COVID-19 vaccines, it’s
not the only tool”, stressed Tedros. Vaccination against malaria
does not replace or reduce the need for other measures,
including bednets, or seeking care for
fever.”
