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W.H.O. Endorses Groundbreaking Malaria Vaccine For Children

Source: Unsplash/Mufid Majnun

Groundbreaking vaccine for malaria—the biggest cause of childhood illness and death in sub-Saharan Africa—could be rolled out to billions as World Health Organization experts give approval.

Historic RTS,S/AS01 recommendation can reinvigorate the fight against malaria

The World Health Organization (WHO) is recommending widespread use of the RTS,S/AS01 (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.

“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.”

Vaccinated children do better at school, with economic benefits that ripple across their communities. Today, vaccines are estimated to be one of the most cost-effective means of advancing global welfare.
Thanks to immunisation efforts worldwide, children are able to walk, play, dance and learn. Vaccinated children do better at school, with economic benefits that ripple across their communities. Today, vaccines are estimated to be one of the most cost-effective means of advancing global welfare. Source: Afro.who.int

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.

"For centuries, malaria has stalked sub-Saharan Africa, causing immense personal suffering,” said Dr Matshidiso Moeti, WHO Regional Director for Africa. “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. 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.”

WHO recommendation for the RTS,S malaria vaccine

Based on the advice of two WHO global advisory bodies, one for immunization and the other for malaria, the Organization recommends that:

WHO recommends that in the context of comprehensive malaria control the RTS,S/AS01 malaria vaccine be used for the prevention of P. falciparum malaria 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 4 doses in children from 5 months of age for the reduction of malaria disease and burden.

Source: WHO.int  

Vaccines are among the greatest advances in global health and development. For over two centuries, vaccines have safely reduced the scourge of diseases like polio, measles and smallpox, helping children grow up healthy and happy. They save more than five lives every minute – preventing up to three million deaths a year, even before the arrival of COVID-19. © UNICEF/UN0287582/Diefaga
Vaccines are the world’s safest method to protect children from life-threatening diseases. Vaccines are among the greatest advances in global health and development. For over two centuries, vaccines have safely reduced the scourge of diseases like polio, measles and smallpox, helping children grow up healthy and happy. They save more than five lives every minute – preventing up to three million deaths a year, even before the arrival of COVID-19. © UNICEF/UN0287582/Diefaga Source: UNICEF.org

A Summary of key findings of the malaria vaccine pilots:

Key findings of the pilots informed the recommendation based on data and insights generated from two years of vaccination in child health clinics in the three pilot countries, implemented under the leadership of the Ministries of Health of Ghana, Kenya and Malawi. Findings include:

  • Feasible to deliver: Vaccine introduction is feasible, improves health and saves lives, with good and equitable coverage of RTS,S seen through routine immunization systems. This occurred even in the context of the COVID-19 pandemic.
  • Reaching the unreached: RTS,S increases equity in access to malaria prevention.
    • Data from the pilot programme showed that more than two-thirds of children in the 3 countries who are not sleeping under a bednet are benefitting from the RTS,S vaccine.
    • Layering the tools results in over 90% of children benefitting from at least one preventive intervention (insecticide treated bednets or the malaria vaccine).
  • Strong safety profile: To date, more than 2.3 million doses of the vaccine have been administered in 3 African countries – the vaccine has a favorable safety profile.  
  • No negative impact on uptake of bednets, other childhood vaccinations, or health seeking behavior for febrile illness. 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.
  • High impact in real-life childhood vaccination settings: 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.
  • Highly cost-effective: 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.

Financial support

Financing for the pilot programme has been mobilized through an unprecedented collaboration among three key global health funding bodies: Gavi, the Vaccine Alliance; the Global Fund to Fight AIDS, Tuberculosis and Malaria; and Unitaid.

Source: WHO.int 

Some 20 million children miss out on life-saving vaccines annually. The most poor and marginalised children – often most in need of vaccines – continue to be the least likely to get them. Many live in countries affected by conflict, in remote areas, or where polio remains endemic. Low immunisation rates also compromise progress in areas of maternal and child health and well-being.
Despite these longstanding benefits, low immunisation levels persist. Some 20 million children miss out on life-saving vaccines annually. The most poor and marginalised children – often most in need of vaccines – continue to be the least likely to get them. Many live in countries affected by conflict, in remote areas, or where polio remains endemic. Low immunisation rates also compromise progress in areas of maternal and child health and well-being. Source: Afro.who.int

Bullet points:

  • The malaria vaccine, RTS,S, acts against P. falciparum, the most deadly malaria parasite globally, and the most prevalent in Africa.
  • The Malaria Vaccine Implementation Programme is generating evidence and experience on the feasibility, impact and safety of the RTS,S malaria vaccine in real-life, routine settings in selected areas of Ghana, Kenya and Malawi.
  • Pilot malaria vaccine introductions are led by the Ministries of Health of Ghana, Kenya and Malawi.
  • The pilot programme will continue in the 3 pilot countries to understand the added value of the 4th vaccine dose, and to measure longer-term impact on child deaths.
  • The Malaria Vaccine Implementation Programme is coordinated by WHO and supported by in-country and international partners, including PATH, UNICEF and GSK, which is donating up to 10 million doses of the vaccine for the pilot.
  • The RTS,S malaria vaccine is the result of 30 years of research and development by GSK and through a partnership with PATH, with support from a network of African research centres.
  • The Bill & Melinda Gates Foundation provided catalytic funding for late-stage development of RTS,S between 2001 and 2015.
Source: WHO.int 

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