Amongst all the gloom which seems to hang over the world at the moment- the ongoing COVID pandemic, the threat of climate change, the emerging trade wars and the numerous ongoing violent conflict across large parts of the world, one piece of very good news emerged in early October. In a major announcement the World Health Organisation (WHO) announced its approval of the first ever malaria vaccine- RTSS (also known as Mosquirix). This is a huge breakthrough in combatting this terrible disease which has caused such an enormous amount of human suffering over the centuries. The approval follows on from the results of a successful pilot programme in Malawi, Ghana, and Kenya.
Children younger than five are the most vulnerable to malaria. The vaccine is designed to be given in four doses to children in their first 18months of life. Evidence form the pilot suggests that the vaccine has a 40% efficacy rate against the child catching malaria. In cases where the child does contract malaria the vaccine appears to provide a 30% improvement in the chances of not developing a severe case.
This development of a new vaccine is potentially very good news for Africa in particular, where 94% of all malaria cases and deaths occur.
It is hoped that further ongoing research e.g. by Oxford University in Burkina Faso will lead to more efficient and effective vaccines but this is a great start .
Whilst before the vaccine, significant progress had been made in recent years, through programmes including insecticide-treated mosquito nets, indoor residual soaring and doses of seasonal malaria chemoprevention, there were still 229 million new malaria cases reported in 2019 with 409,000 deaths , mostly in children under five years. Nigeria is particularly badly affected accounting for 23% of all deaths in the world from malaria. Three quarter of the population live in areas with high transmission rates.
Whilst this scientific breakthrough is to be welcomed, without global co-operation it will not achieve its potential to begin to eliminate malaria. The evidence of the COVID epidemic, in which mass vaccination programmes have barely started in large parts of Africa, whilst the West holds stockpiles of vaccine, suggests that without international and co-ordinated assistance many countries in the developing world will be unable to to exploit this breakthrough. Getting the vaccine to where it is needed will be a huge challenge. The manufacturing capacity for tens of millions of doses each year will have to be developed. Manufacturers won’t do this unless they are guaranteed payment and agreement needs to be reached quickly on underwriting the cost. Distribution infrastructure will need to be set up in each of the malaria-affected countries like Nigeria. Governments in these countries will need to run campaigns to maximise vaccine uptake to make sure it reaches those who need it most. In all of these processes the lessons learned from the COVID pandemic need to be applied.
Early action is needed to identify how the additional resources required can be funded. This will need to include adding up to $2 billion to the approx. $3 billion dollars per annum currently being spent on malaria. It is essential that the West and China start to look at how they can help meet this challenge.
This is now achievable if the international will is there.