Respite for children at severe risk of malaria as WHO endorses proven vaccine

Respite is finally here for millions of children at severe risk of malaria as the World Health Organization (WHO) recommends the widespread use of the groundbreaking malaria vaccine, RTS,S/AS01 (RTS,S).

WHO recommends that in the context of comprehensive malaria control, the malaria vaccine should be used for the prevention of the disease in children living in regions with moderate to high transmission as defined by WHO.

RTS,S/AS01 malaria vaccine should be provided in a schedule of four doses in children from 5 months of age for the reduction of malaria disease and burden.

The recommendation which came on Wednesday is based on results from an ongoing pilot programme that began in Ghana, Kenya and Malawi in 2019 and has reached more than 800 000 children.

“This is a historic moment. The long-awaited malaria vaccine for children is a breakthrough for science, child health and malaria control,” said WHO Director-General Dr Tedros Adhanom Ghebreyesus. “Using this vaccine on top of existing tools to prevent malaria could save tens of thousands of young lives each year.”

Malaria remains a primary cause of childhood illness and death in sub-Saharan Africa. More than 260 000 African children under the age of five die from malaria annually.

In recent years, WHO and its partners have been reporting a stagnation in progress against the deadly disease.

Matshidiso Moeti, WHO Regional Director for Africa described the breakthrough as one long hoped for an effective malaria vaccine and now for the first time ever, it’s being recommended for widespread use.

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“Today’s recommendation offers a glimmer of hope for the continent which shoulders the heaviest burden of the disease and we expect many more African children to be protected from malaria and grow into healthy adults,” she said.

Key Findings

WHO’s findings demonstrates that the vaccine introduction is feasible, with good and equitable coverage seen through routine immunization systems.

Data from the pilot programme also shows that more than two-thirds of children in the three countries who are not sleeping under a bednet are benefitting from the vaccine.

More than 2.3 million doses of the vaccine have been administered in three African countries to date, an indication the vaccine has a good safety profile.

According to the global health body, no negative impact has been recorded on uptake of bednets, other childhood vaccinations, or health seeking behavior for febrile illness.

And in areas where the vaccine has been introduced, there has been no decrease in the use of insecticide-treated nets, uptake of other childhood vaccinations or health seeking behavior for febrile illness.

The test-run has also seen significant reduction (30%) in deadly severe malaria, even when introduced in areas where insecticide-treated nets are widely used and there is good access to diagnosis and treatment.

Modelling estimates that the vaccine is cost effective in areas of moderate to high malaria transmission.

Next steps for the WHO-recommended malaria vaccine will include funding decisions from the global health community for broader rollout, and country decision-making on whether to adopt the vaccine as part of national malaria control strategies.

Malaria in Nigeria

While Malaria the prevalence in Nigeria has declined 23 percent in 2020 from 42 percent in 2010, it still tops the sources of morbidity and mortality in the country.

Nigeria accounts for 27 percent of the global malaria cases and 23 percent of global malaria deaths based on data from the World Malaria Report 2020.

In the next five years, the government aims to reduce malaria prevalence to a parasite prevalence of less than 10 people and mortality attributable to malaria to less than 50 deaths per 1,000 live births by 2025 as reflected in the new malaria strategic plan 2021 to 2025.