October 7, 2021
Malaria is one of the primary causes of childhood illness and death in sub-Saharan Africa, responsible for the deaths of more than 260,000 African children under the age of five every year, and 400,000 people in total. This week, for the first time, the World Health Organisation (WHO) has recommended a vaccination against the disease, following successful trials in Ghana, Kenya, and Malawi. This historic step could provide a significant new tool in the fight against the disease, and experts hope that the search for even more effective vaccines will pick up momentum again, after slow progress in recent years.
The RTS,S vaccine, also known as Mosquirix, was developed by the British firm GlaxoSmithKline (GSK), and is the result of 30 years of research and development by the company, in partnership with international health NGO PATH, and a network of African research centres.
“This long-awaited landmark decision can reinvigorate the fight against malaria in the region at a time when progress on malaria control has stalled,” said Thomas Breuer, GSK’s chief global health officer. “Both real-world evidence and clinical trial data show that RTS,S, alongside other malaria prevention measures, has the potential to save hundreds of thousands of lives.”
Following four years of clinical trials, the vaccine was found to have limited efficacy when used alone, preventing 39% of malaria cases and 29% of severe malaria cases. However, when used in combination with antimalarial drugs, there was a 70% reduction in hospitalisations and deaths.
WHO Director General Dr Tedros Adhanom Ghebreyesus, who started his career as a malaria researcher, described the breakthrough as “a historic day”, at a press conference in Geneva to announce the news. The vaccine pilot schemes in the three countries, which involved 800,000 children in the three countries since 2019, was found to be feasible to deliver, safe, high-impact, and cost-effective, all crucial elements in sub-Saharan Africa where the logistics of distribution in remote areas with patchy healthcare coverage present a challenge of their own.
Health experts now hope that the announcement will spur the development of other vaccines, in order to reach the WHO’s goal of 75% efficacy. Researchers from the Jenner Institute at Oxford University announced earlier this year that a vaccine they were developing has shown efficacy of up to 77% in limited trials, and they are now also starting a larger roll-out to confirm their results.
Children involved in the trials have received up to three doses of the vaccine. The trial will now continue to assess the added value of a fourth dose and measure long-term impact on mortality rates. GSK is donating up to 10 million doses for the pilot, and has committed to supplying 15 million doses per year going forward at no more than 5% above the cost of production.The Malaria Vaccine Implementation Programme is coordinated by the WHO, and implemented in-country by the Ministries of Health of Ghana, Malawi and Kenya, with support from PATH and UNICEF, and an unprecedented collaborative funding stream from donors including Gavi, the Vaccine Alliance; the Global Fund to Fight AIDS, Tuberculosis and Malaria; and Unitaid, which together pledged US$70 million. The Bill and Melinda Gates Foundation was also engaged in funding from 2001 to 2015.
