WHO recommended malaria vaccine starts being shipped to Africa
Shipments of the world’s first WHO-recommended malaria vaccine (RTS,S) have begun with 331,200 doses landing on Tuesday night in Yaoundé, Cameroon — heralding final steps toward broader vaccination of the deadly disease
A statement from Gavi (The Vaccine Alliance), UNICEF and the World Health Organisation (WHO), the delivery to Cameroon is the first to a country not previously involved in the malaria vaccine pilot programme and signals that scale-up of vaccination against malaria across the highest-risk areas on the African continent will begin shortly.
The statement added that “nearly every minute, a child under five dies of malaria [and that] in 2021, there were 247 million malaria cases globally, which led to 619,000 deaths”.
“Of these deaths, 77% were children under 5 years of age, mostly in Africa. Malaria burden is the highest on the African continent, which accounts for approximately 95% of global malaria cases and 96% of related deaths in 2021.
“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.
“This reflects the fact that several countries are now in the final stage of preparations for malaria vaccine introduction into routine immunisation programmes, which should see first doses administered in first quarter of 2024.”
The statement further says comprehensive preparations are needed to introduce any new vaccine into essential immunisation programmes – such as training of healthcare workers, investing in infrastructure, technical capacity, vaccine storage, community engagement and demand — and sequencing and integrating rollout alongside the delivery of other vaccines and health interventions.
“Implementing the malaria vaccine rollout has the added challenge of a four-dose schedule which requires careful planning to effectively deliver.
“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 2 million children have been reached with the malaria vaccine in the three African countries through MVIP – resulting in a remarkable 13% 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 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.”
According the statement, 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 similar high public health impact. The choice of which vaccine to be used 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 statement further says, adding: “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 gamechanger for malaria control efforts, and could save tens of thousands of lives each year.
“However, malaria vaccines are not a standalone solution. They should be introduced in the context of the WHO-recommended package of malaria control measures which include insecticide-treated nets, indoor residual spraying, intermittent preventive treatment in pregnant women, antimalarials, effective case management, and treatment, all of which have helped to reduce malaria-related deaths since 2000.
“Importantly, the MVIP showed that delivering vaccines alongside non-vaccine interventions can reinforce the uptake of other vaccines and the use of insecticide treated nets, and overall boost access to malaria prevention measures.”
David Marlow, CEO of Gavi, the Vaccine Alliance, is quoted in the statement as saying:“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 rollout this historic vaccine through Gavi programmes and work with partners to ensure it is delivered alongside other vital measures.”
On their part, UNICEF Executive Director, Catherine Russell added credence that this could be a real gamechanger in the fight against malaria, saying: “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.”
WHO Director-General Dr Tedros Adhanom Ghebreyesus said: “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,” he said while WHO Regional Director for Africa Dr Matshidiso Moeti added that the vaccine is a vital addition to the existing set of malaria prevention tools and will help bolster efforts to reverse the rising trend in cases and further reduce deaths.
Gavi, the Vaccine Alliance is a public-private partnership that helps vaccinate more than half the world’s children against some of the world’s deadliest diseases.
The Vaccine Alliance brings together developing country and donor governments, the WHO, UNICEF, the World Bank, the vaccine industry, technical agencies, civil society, the Bill & Melinda Gates Foundation and other private sector partners.
Since its inception in 2000, Gavi has helped to immunise a whole generation – over 1 billion children – and prevented more than 17.3 million future deaths, helping to halve child mortality in 78 lower-income countries.
Gavi also plays a key role in improving global health security by supporting health systems and outbreak response as well as funding global stockpiles for Ebola, cholera, meningococcal and yellow fever vaccines.
After two decades of progress, Gavi is now focused on protecting the next generation, above all the zero-dose children who have not received even a single vaccine shot.
The Vaccine Alliance employs innovative finance and the latest technology – from drones to biometrics – to save lives, prevent outbreaks before they can spread and help countries on the road to self-sufficiency.
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