In a notable first, following successful pilot immunisation programmes in Ghana, Kenya and Malawi, the World Health Organization (WHO) has recommended that the RTS,S malaria vaccine be rolled out across sub-Saharan Africa and in other regions with moderate to high malaria transmission.
Financing for the pilot programme has been mobilized through d collaboration between three key global health funding bodies: Gavi, the Vaccine Alliance; the Global Fund to Fight AIDS, Tuberculosis and Malaria; and Unitaid.
WHO Director-General Dr Tedros Adhanom Ghebreyesus said, “This is a historic moment. The long-awaited malaria vaccine for children is a breakthrough for science, child health and malaria control.” He added, “Using this vaccine on top of existing tools to prevent malaria could save tens of thousands of young lives each year.”
The WHO estimates that 94 percent of the 229 million cases of malaria that occur every year are in Africa. Worldwide, there are 409,000 deaths from the disease per annum and over 260,000 children died from the disease in 2019.
“We’ve been looking for a malaria vaccine for over 100 years now, it will save lives and prevent disease in African children,” said Dr Pedro Alonso, the WHO’s Global Malaria Programme director. “From a scientific perspective, this is a massive breakthrough, from a public health perspective this is a historical feat.”
The news comes at a positive time for the vaccine’s developer, British giant GSK, whose long-term business strategy has been queried by analysts and shareholders alike. Thomas Breuer, the firm’s Chief Global Health Officer said: “GSK is proud that RTS,S, our ground-breaking malaria vaccine, developed over decades by our teams and partners, can now be made available to children in sub-Saharan Africa and other regions with moderate to high malaria transmission. This long-awaited landmark decision can reinvigorate the fight against malaria in the region at a time when progress on malaria control has stalled. Both real world evidence and clinical trial data show that RTS,S, alongside other malaria prevention measures, has the potential to save hundreds of thousands of lives.”
WHO 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.