Nigeria might get an allocation of malaria vaccine at the second window of supply planned by the World Health Organization (WHO), after missing the initial rollout that saw 18 million doses allocated to 12 other African countries.
About 6.9 million doses of the first batch were allotted to Ghana, Kenya, and Malawi where the Malaria Vaccine Implementation Programme (MVIP) began in 2019, according to the WHO’s Framework for Allocation of Limited Malaria Vaccine Supply.
Eight other countries including Uganda, Burundi, Burkina Faso, the Democratic Republic of the Congo, Sierra Leone, Benin, Cameroon, and Liberia are set to receive over 10.5 million doses over the next two years to introduce the vaccine into their routine immunization programmes for the first time.
Niger is expected to get a partial supply of 565,000 of over 1 million planned allocations.
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The WHO said it is exploring opportunities to fix the current supply scarcity in hopes that a second malaria vaccine, R21/Matrix-M, under review is confirmed safe, efficacious, and at par with the quality of manufacturing standards.
If it ticks all boxes, the vaccine could be recommended for use and potentially available by the first quarter of 2024, WHO said.
However, the National Agency for Food and Drug Administration and Control (NAFDAC) already gave conditional approval for the vaccine use in Nigeria last April and a clinical trial is also being run for malaria vaccine by the agency.
Raphael Onyilo, head of Advocacy and Communications, National Malaria Elimination Programme (NMEP) said efforts were ongoing to ensure Nigeria is enlisted for the next batch of allocation in a response to BusinessDay.
But he didn’t indicate the stage of the effort.
Due to the high demand for the first malaria vaccine, RTS, S/AS01, which got WHO’s approval for the prevention of malaria in children, only 14 out of 28 applications submitted by countries in the first two application opportunities were approved by Gavi, the Vaccine Alliance in 2022.
Nigeria was not dimmed fit to be on that list for unclear reasons.
Annual global demand for malaria vaccines is estimated at 40 to 60 million doses by 2026 alone, growing to 80 to 100 million doses each year by 2030, according to WHO.
The available vaccine supply for the period 2023-2025 is currently limited to 18 million doses and falls short of the vaccine dose requirements for the countries recommended by Gavi IRC for approval.
The first doses of the vaccine are expected to arrive in countries during the last quarter of 2023, with countries starting to roll them out by early 2024.
Malaria remains one of Africa’s deadliest diseases, killing nearly half a million children under the age of 5, and accounting for approximately 95 percent of global malaria cases and 96 percent of deaths in 2021.
Despite carrying the largest burden of the disease in the world, with more than 23 percent of deaths recorded according to the World Malaria Report 2020, Nigeria’s failure to participate in the clinical trials due to infrastructural deficits is haunting its access to critical vaccines.
According to the framework for allocation, one of the key considerations is to allocate the vaccine to countries with areas of greatest need, where the malaria disease burden in children and the risk of death are highest.
Many stakeholders believe Nigeria qualifies in this regard.
The second priority principle is to maximise health impact by allocating the vaccine to countries for use in areas where the expected health impact is greatest. The third is to achieve equity by prioritising countries that commit to fairness, and addressing the needs of marginalised individuals and communities in their malaria vaccination programmes
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