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The World’s First Malaria Vaccine to Be Rolled Out in Ghana, Kenya and Malawi in 2018

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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.

Sources:

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.

World’s First Malaria Vaccine Approved

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The world’s first malaria vaccine has been approved by the European Medicines Agency (EMA), setting the stage for a final assessment by the World Health Organisation (WHO) before the drug can be accepted by countries ravaged by the disease.

GlaxoSmithKline, the pharmaceutical company behind the drug Mosquirix, announced the approval by regulators last week, indicating that the European assessors had adopted a positive scientific opinion for its use in children aged six weeks to 17 months.

The drug, also known as RTS,S, was co-developed with the PATH Malaria Vaccine Initiative, and prevents malaria caused by the Plasmodium alciparum parasite. Global anticipation for the vaccine is immense, with despairing statistics highlighting how much of a problem malaria still is in the developing world.

Figures from 2013 indicate that the disease claims a child every single minute, with an estimated overall death toll that year of 584,000 people. The disease is prevalent in tropical and subtropical regions, with sub-Saharan Africa as the worst affected area: of the 584,000 deaths in 2013, 90 percent occurred in the region, with 83 percent in children under the age of five.

“Today’s scientific opinion represents a further important step towards making available for young children the world’s first malaria vaccine,” said Sir Andrew Witty, CEO of GlaxoSmithKline, in a statement. “While RTS,S on its own is not the complete answer to malaria, its use alongside those interventions currently available such as bed nets and insecticides, would provide a very meaningful contribution to controlling the impact of malaria on children in those African communities that need it the most.”

Having been approved by the EMA, the drug will now be reviewed by independent advisory groups on behalf of the WHO, to devise recommendations on how it could be used alongside other medicines to help prevent the disease in countries where it is approved for use by national regulators. It’s believed that the WHO’s recommendations may be announced this yeavr, but the national processes involving specific sub-Saharan countries will take additional time to be resolved. It’s hoped the vaccine will become available within the next few years.

Source: Science Alert