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World’s first malaria vaccine piloted in Malawi babies

Vaccine prevents only four in 10 cases – but expected to be ‘promising tool’ in saving thousands of lives

Louise Prime

Wednesday, 24 April 2019

The World Health Organization (WHO) has welcomed the launch of the world’s first malaria vaccine, in a landmark pilot programme launched yesterday in Malawi for babies and children up to two years old; Ghana and Kenya will be joining in the next few weeks. Although the vaccine prevents fewer than half of cases, it is expected to reduce the annual malaria death toll by hundreds of thousands.

WHO pointed out that although African countries have made "tremendous progress" in the fight against malaria using core disease-cutting tools such as insecticide-treated mosquito nets, indoor spraying with insecticides and antimalarial medicines, malaria morbidity and mortality remain "stubbornly high" in some areas where these approaches have been adopted. Its own data reveal that there were an estimated 435,000 malaria-related deaths globally (most among children) and 219 million new cases of the disease in 2017, and sub-Saharan Africa carries more than 90% of the global disease burden.


WHO said the vaccine RTS,S, which acts against Plasmodium falciparum (the most deadly malaria parasite globally and the most prevalent in Africa), has taken 30 years to develop. In large-scale phase 3 clinical trials so far, among children who received four doses, the vaccine prevented four in 10 cases of clinical malaria; three in 10 cases of severe malaria; and six in 10 cases of severe malaria anaemia, the most common reason children die from malaria (compared with children who did not receive RTS,S). There were also significant reductions in overall hospital admissions and blood transfusions, which are required to treat severe malaria anaemia. WHO pointed out that these and other benefits were in addition to those already seen through the use of insecticide-treated nets (bed nets); prompt diagnosis; and effective antimalarial treatment.

In the pilot programme, RTS,S will be made available to young children in selected areas of high malaria transmission in Ghana, Kenya and Malawi through routine immunisation services. The vaccine will be given in four doses: three between five and nine months of age and the fourth dose provided around the 2nd birthday.

WHO director-general Dr Tedros Adhanom Ghebreyesus commented: “We have seen tremendous gains from bed nets and other measures to control malaria in the last 15 years, but progress has stalled and even reversed in some areas. We need new solutions to get the malaria response back on track, and this vaccine gives us a promising tool to get there. The malaria vaccine has the potential to save tens of thousands of children’s lives.”

WHO regional director for Africa Dr Matshidiso Moeti said: “Malaria is a constant threat in the African communities where this vaccine will be given. The poorest children suffer the most and are at highest risk of death.”

She added: “This is a day to celebrate as we begin to learn more about what this tool can do to change the trajectory of malaria through childhood vaccination.”

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