Malaria is one of the world’s most deadly diseases even though it is highly preventable and treatable. Malaria causes approximately 881,000 deaths every year, with nine out of ten deaths occurring in sub-Saharan Africa.
Effective control and treatment of malaria has been very challenging and efforts have been made to reduce the burden of malaria in an integrated approach that combines preventative measures, such as long-lasting insecticide-treated bed nets (LLINs) and indoor residual spraying (IRS), with improved access to effective anti-malarial drugs.
However, malaria is a disease that stems from and causes poverty, and many at-risk populations live in extremely destitute, remote areas. Poor, rural families are the least likely to have access to these preventative measures that are fundamental to malaria control, and may live kilometres from the nearest healthcare facility. They are also less able to afford treatment once infection has occurred.
In addition to the human cost of malaria, the economic burden of the disease is vast. It is estimated that malaria costs African countries more than US$12 billion every year in direct losses, even though the disease could be controlled for a fraction of that sum. For Nigeria alone the direct loss to the economy is estimated at GBP530 million annually.
Up to 40% of African health budgets are spent on malaria each year, and on average, a malaria-stricken family loses a quarter of its income through loss of earnings and the cost of treating and preventing the disease. Malaria causes an average loss of 1.3% of economic growth per year in Africa.
There is a ray of hope in Africa as the world first malaria vaccine is to be rolled out in Ghana, Kenya and Malawi in 2018. This injectable vaccine known as “RTS,S or Mosquirix” was developed by British drugmaker GlaxoSmithKline (GSK) and will be offered for babies and children in high risk areas as part of real life trials as reported by the World Health Organisation (WHO).
In clinical trials it is proved only partially effective, and it needs to be given in a four-dose schedule, but it is the first-regulator-approved vaccine against the mosquito- borne disease. The WHO, who is in process of assessing whether to add the shot to the core package of WHO-recommended measures for malaria prevention, has said it firsts wants to see the results of on-the ground testing in a pilot programme.
“Information gathered in the pilot will help us make decisions on the wider use of this vaccine,” Matshidiso Moeti, the WHO’s African regional director said in a statement as the three pilot countries were announced.
“Combined with existing malaria interventions, such a vaccine would have the potential to save tens of thousands of lives in Africa.”
Global efforts in the last 15 years cut the malaria toll by 62 percent between 2000 and 2015. The WHO pilot programme will assess whether the Mosquirix’s protective effect in children aged 5 to 17 months can be replicated in real life. It will also assess the feasibility of delivering the four doses needed and explore the vaccine’s potential role in reducing the number of children killed by the disease.
The WHO said Malawi, Kenya and Ghana were chosen for the pilot due to several factors, including having high rates of malaria as well as good malaria programmes, wide use of bed-nets and well-functioning immunization programmes.
Each of the three countries will decide on the districts and regions to be included in the pilots, the WHO said, with high malaria areas getting priority since these are where experts expect to see most benefit from the use of the vaccine. The vaccine was developed by GSK in partnership with the non-profit PATH Malaria Vaccine Initiative and part-funded by the Bill & Melinda Gates Foundation.
The WHO said in November it had secured full funding for the first phase of the RTS,S pilots, with 15 million from the Global Fund to Fight AIDS, Tuberculosis and up to 27.5 million and 9.6 million respectively from the GAVI Vaccine Alliance and UNITAID for the first four years of the programme.
This significant development will help to address the continuing challenges presented by malaria in Africa in the years ahead and hopefully bring an end to this deadly disease.
The Hindu, April 25, 2017.
Kokwaro G. (2009) Ongoing challenges in the management of malaria. Malaria Journal, 8(Suppl 1):S2 doi:10.1186/1475-2875-8-S1-S2.