How effective is it and when is it available?

Children in Malawi, as the photo shows here, were part of a pilot program
AFP

Researchers and health professionals have celebrated the approval of the World Health Organization for the widespread use of the world’s first malaria vaccine.

With more than 260,000 children under the age of five dying from malaria every year in sub-Saharan Africa, this decades-old development could save tens of thousands of lives, the organization says.

In this report, we address some important questions related to the production and distribution of the vaccine.

How effective is the vaccine?

The vaccine known as “RTS,S” proved effective six years ago, preventing 40% of malaria cases and 30% of severe infections.

Since 2019, researchers have been implementing larger pilot vaccination programs in Ghana, Kenya and Malawi.

More than 800,000 children have received at least one dose and the World Health Organization says there are no safety concerns.

Obviously, it would be better if the vaccine provided a higher rate of protection. But many believe that with hundreds of millions of cases of infection, a 40% reduction would still mean saving a significant number of lives.

“This is a moderately effective vaccine,” Pedro Alonso of the World Health Organization told the BBC. [لكن] Avoiding 30-40% of injuries and deaths can be of great benefit to people.”

Health authorities are also keen to stress that this is a new weapon in the fight against malaria that will be used in combination with other preventive measures.

More than 800,000 children have received at least one dose and the World Health Organization says there are no safety concerns
Getty Images
More than 800,000 children have received at least one dose and the World Health Organization says there are no safety concerns

How does the vaccine work?

Malaria is caused by a parasite that invades and destroys blood cells in order to reproduce, and is spread by a mosquito bite.

The vaccine targets the most deadly and most common parasite in Africa: Plasmodium falciparum.

Dr Alonso said he is trying to deal with the form of the parasite that enters the victim’s blood shortly after being bitten, by partially blocking access to human cells and thus preventing disease.

To ensure the vaccine is effective, a child needs 4 doses, at five, six and seven months of age, and then a final booster dose when the child is about 18 months old.

Children are the most likely to die from malaria because, unlike adults, they have not had the opportunity to build immunity.

How much will the vaccine cost and who will pay?

The vaccine was developed by pharmaceutical giant GSK, which pledged to supply the doses at a manufacturing cost plus 5%, but did not specify a final price.

And when it comes to procuring a vaccine, it is up to countries and donors to provide the funding.

“The international funding community must now discuss and then decide how to buy the vaccine,” Thomas Brewer, chief global health officer at GSK, told the BBC.

Rose Galango, who helps coordinate the pilot program in Kenya, said authorities are awaiting global guidance on how to fund the vaccine as part of the national immunization programme.

Currently in Kenya, most vaccine funding comes from donors such as the Gavi Vaccine Alliance and the Bill & Melinda Gates Foundation.

What is the distribution schedule?

Pilot programs will continue in Ghana, Kenya and Malawi. GSK says it has donated 10 million doses for the study and so far a quarter of it has been used.

The company has committed to providing 15 million doses a year. If he finds the money, Brewer said, they could start making it available for wider use from the end of 2022 or early 2023.

But this number may not be enough. By the end of the decade, as many as 100 million doses may be needed each year, according to Ashley Burkett, who helped work on the vaccination program.

What infrastructure is required?

Since the vaccination is intended for children under the age of two, it can be combined with other child vaccination programmes, so no additional infrastructure may be required.

There needs to be more public education and some training for health workers.

Dr Galango told the BBC that in the pilot program in Kenya, more than 200,000 children were vaccinated and made available in rural and remote areas through outreach programs and remote clinics.

What other vaccines are being developed?

Work is underway on other vaccines, including one from Oxford University in the UK. And in April, researchers reported early trials indicating it was 77% effective.

But developing malaria vaccines is a long process because it is a much more complex disease than, for example, treating the coronavirus.

“RTS,S” is the first malaria vaccine that has undergone all the necessary tests and experiments, but the World Health Organization says that the availability of another vaccine “will be very useful to combat malaria” because it will help meet the expected high demand.

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