The World Health Organization (WHO) recommended extensive use of RTS,S malaria vaccine among children in sub-Saharan Africa and in other regions with moderate to high P. falciparum malaria transmission.
The recommendation is based on results from an ongoing pilot programme in Ghana, Kenya and Malawi that has reached more than 800, 000 children since 2019, WHO said.
“This is a historic moment. The long-awaited malaria vaccine for children is a breakthrough for science, child health and malaria control,” said Organization’s Director-General Dr. Tedros Adhanom.
“Using this vaccine on top of existing tools to prevent malaria could save tens of thousands of young lives each year,” he noted.
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, the release from the organization indicated.
"For centuries, malaria has stalked sub-Saharan Africa, causing immense personal suffering. We have long hoped for an effective malaria vaccine and now for the first time ever, we have such a vaccine recommended for widespread use. We expect many more African children to be protected from malaria,” said Dr Matshidiso Moeti, WHO Regional Director for Africa.”
Consequently, WHO recommended extensive use of RTS,S/AS01 to prevent P. falciparum malaria in children living in regions with moderate to high transmission. The Organization correspondingly recommends that the vaccine should be provided in a schedule of four doses in children from five months of age for the reduction of malaria disease and burden.
Key findings of the pilots in the three countries implemented under the leadership of the Ministries of Health of Ghana, Kenya and Malawi indicate RTS,S increases equity in access to malaria prevention.
It is also disclosed feasibility and effectiveness of the vaccine to improve health and saves life, with good and equitable coverage. Two-thirds of children in the three countries who are not sleeping under a mosquito net are benefitting from the RTS,S vaccine.
To date, more than 2.3 million doses of the vaccine have been administered in three African countries – the vaccine has a favorable safety profile. 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.
Safeguarding children
There are more than 100 types of malaria parasite. The RTS,S vaccine targets the one that is most deadly and most common in Africa: Plasmodium falciparum.
However, there were doubts the vaccine would work in the real world as it requires four doses to be effective. The first three are given a month apart at five, six and seven months old, and a final booster is needed at around 18 months.
Unbeatable disease
Malaria is caused by a parasite which is far more insidious and sophisticated than the virus that causes today’s pandemic.
The malaria parasite has evolved to evade people’s immune system. Malaria has a complicated life cycle across humans and mosquitoes. It morphs between different forms as it infects liver cells and red blood cells.
RTS,S is only able to target the sporozoite form of the parasite - stage between being bitten by a mosquito and the parasite getting to the liver.
That’s why the vaccine is 'only' 40% effective. However, this is still a remarkable success and paves the way for the development of more potent vaccines.
The vaccine, developed by the pharmaceutical giant GSK, is not going to replace all the other measures for controlling malaria such as insecticide-treated bed nets. It will be used alongside them to get closer to the goal of zero deaths from malaria.
And it won't be used outside of Africa where different forms of malaria, which the vaccine can't protect against, are more prevalent.
PATH Malaria Vaccine Initiative Director Dr. Ashley Birkett reportedly said that rolling out the vaccine is a significant that would take away fear from families.
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