The rollout of malaria vaccines in Nigeria is facing a $250 million funding gap, with the government yet to establish a financing plan for procuring the doses even as the disease claims 194,000 lives annually.
Muhammad Pate, Nigeria’s minister of health and social welfare, while speaking with BusinessDay in an exclusive interview in Abuja weekend, said the R21/Matrix M approved by the World Health Organization (WHO) for protection against malaria are expensive and an estimated $250 million is required to cover the cost.
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Pate said the government is currently deliberating potential funding sources, with discussions centered on whether the federal government, state governments, the private sector, or even individuals will contribute to the financing – alongside a strategic deployment plan that will overcome factors that may fuel vaccine hesitancy.
“We want to identify where the money is going to come from. Is it only the federal government, or are states going to contribute? Will the private sector and individuals also pay? An estimated $250 million dollars will be required, but where is that going to come from? Who is going to pay for it? This is the hard work that is being done so that we introduce such new vaccines in a systematic way while optimising the most basic interventions,” the minister said.
Malaria remains a leading cause of morbidity and mortality in Nigeria, with the country bearing the highest burden globally. According to the World Health Organization (WHO), Nigeria recorded an estimated 68 million cases and 194,000 malarial deaths in 2022, translating into over 500 deaths daily.
The WHO 2023 malaria report showed Nigeria accounted for 27 percent of the global malaria burden. Children are the most vulnerable population with as much as 36 percent of under-five mortality in Nigeria attributed to malaria.
The global health body approved two vaccines: the RTS,S known by the brand name Mosquirix, and the more effective R21/Matrix-M, which has shown 77 percent efficacy in initial trials.
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The R21, developed through a collaboration involving the Jenner Institute at the University of Oxford, the Kenya Medical Research Institute, the London School of Hygiene and Tropical Medicine, Novavax, and the Serum Institute of India was approved by the National Agency for Food and Drug Administration and Control (NAFDAC) in April 2023 to pave the way for the rollout of the vaccines, which is hoped to save millions of lives
Côte d’Ivoire is the first country to roll out the R21/Matrix-M vaccine and it has shown promising results in reducing severe cases and deaths in children.
While Côte d’Ivoire has already begun the vaccine roll- out, Nigeria’s plans are stalled by the need for a robust financing and deployment strategy.
Pate stressed that the high cost of the vaccines neccesitates an effective financing and deployment plan to avoid wastages and ensure optimum use.
“When you talk about malaria vaccines, you don’t just wake up and buy them when you don’t have enough money to even pay for what you know already works. You have to be careful how you plan, how you ensure that people are educated, the health workers are ready, the delivery mechanisms are ready. Vaccines by themselves are useless unless people are vaccinated,” he said.
“The vaccines are more expensive than some of the simpler vaccines that we have not yet fully utilized. For instance, measles vaccine is less than a dollar per dose but there are many children that have not been reached by these vaccines.
So, when you go and mobilise malaria vaccine that is expensive and then some misguided elements who think they are educated but have absolutely no clue about what they’re talking about will discourage people from taking them and end up wasting them,” he further said..
In the meantime, the government is focusing on other cost-effective measures to combat malaria such as deploying bed nets, seasonal malaria chemoprophylaxis, which involves administering anti-malaria medication to children twice a year, and intermittent presumptive therapy for pregnant women.
Pate stressed that these simpler cost-effective interventions are crucial and should be optimised even as the government prepares to introduce the new malaria vaccines.
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The minister revealed that some doses of the malaria vaccine have been secured and will be deployed in Bayelsa and Kebbi states as part of a pilot rollout. This will allow the government to assess the effectiveness of the deployment strategy before expanding the programme nationwide.
“We’ve secured some doses of this malaria vaccine which will be deployed to Bayelsa and and Kebbi states so that we see how the rollout goes, and then in parallel, identify where the money is going to come from,” he noted.
The minister also highlighted the challenges posed by misinformation and vaccine hesitancy, which have undermined previous vaccination efforts in Nigeria, and expressed concern that ‘misguided elements’ who spread false information about vaccines could undermine the effectiveness of the malaria vaccination campaign.
Meanwhile, no fewer than nine countries in the African region, including Uganda, Burundi, Burkina Faso, the Democratic Republic of the Congo, Sierra Leone, Benin, Cameroon, and Liberia have rolled out the RTS,S vaccine targeting millions of children.
