The first vaccine approved to fight malaria cut deaths among young children by 13% over nearly 4 years, reported Science. Now, millions of doses of the vaccine are headed to Africa, starting with a shipment last month of 330,000 doses of the RTS.S malaria vaccine to the central African nation of Cameroon. It’s the first country to get the vaccine, other than the three countries that got the vaccine as part of a successful pilot project.
As the World Health Organization notes, “Malaria burden is the highest on the African continent, which accounted for approximately 95% of global malaria cases and 96% of related deaths in 2021. With several African countries now finalizing roll-out plans, an additional 1.7 million doses are set for delivery to Burkina Faso, Liberia, Niger and Sierra Leone in the coming weeks.”
Oddly, the first shipment of doses was sent to Cameroon’s capital city, Yaoundé, not Cameroon’s biggest city and major port, Douala, which has more malaria in its vicinity, and has Cameroon’s biggest airport. Malaria transmission is common in Douala.
As the WHO notes,
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. 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 Q1 2024.
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. Delivering the malaria vaccine 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 PATH, 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.
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