A nurse administers the malaria vaccine to an infant at the Lumumba Sub-County hospital in Kisumu, Kenya, July 1, 2022. A new vaccine, known as RTS,S, is expected to be included in routine immunization programs in several African countries by early next year.BAZ RATNER/Reuters
Health agencies are launching the rollout of a new malaria vaccine across Africa, beginning in Cameroon this week, in a renewed effort to tackle the ancient disease that remains one of the continent’s biggest killers.
The new vaccine is expected to be included in routine immunization programs in several countries by early next year. It offers hope of easing the burden from a disease that kills hundreds of thousands of African children every year.
On Tuesday night, Cameroon received its first shipment under the rollout: a batch of 331,200 doses of the new vaccine, known as RTS,S and marketed under the brand name Mosquirix by the British manufacturer GSK. The delivery is a historic step toward a broader African vaccination campaign, the World Health Organization said.
Cameroon becomes the first country to receive the vaccine after an earlier pilot phase to assess its effectiveness as a public-health tool. The pilot phase began in 2019 in Ghana, Kenya and Malawi, where the vaccine was given to more than two million children. It found a dramatic 13-per-cent drop in mortality among children who received it, along with an even bigger reduction in severe malaria illness and hospitalization.
In preparation for the broader immunization program, a further 1.7 million doses are scheduled for shipment to Liberia, Niger, Burkina Faso and Sierra Leone in the coming weeks. Other countries are expected to receive doses in the following months.
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Malaria is thousands of years old, with records of it in ancient Mesopotamia and Egypt and in the writings of Homer and Plato in ancient Greece. It persisted in parts of Europe and the United States into the early 1900s, killing as many as 300 million people worldwide in the 20th century.
Over the past two decades, malaria-prevention programs have helped to reduce deaths by more than half, but progress has stalled in recent years, and nearly half of the world’s population remains at risk of the disease. There were an estimated 247 million cases of malaria in 2021, almost entirely on the African continent, and nearly 620,000 people died from the disease, mostly children, with 96 per cent of the deaths occurring in Africa.
The new vaccine “could be a real gamechanger in our fight against malaria,” said Catherine Russell, executive director of the United Nations children’s agency, Unicef, in a statement on Wednesday.
“We are entering a new era in immunization and malaria control, hopefully saving the lives of hundreds of thousands of children every year,” she said.
The WHO’s director-general, Tedros Adhanom Ghebreyesus, called it “another breakthrough moment for malaria vaccines and malaria control, and a ray of light in a dark time for so many vulnerable children in the world.”
Under the vaccination program, three doses are given to children under the age of 2. A fourth dose extends the protection for a further one to two years.
Health agencies have secured 18 million doses of the vaccine for the period up to 2025, and the doses have been allocated to a dozen of the highest-risk African countries. But demand far exceeds the supply, since at least 30 countries on the continent are hoping to include a malaria vaccine in their health programs.
A second vaccine, known as R21, manufactured by the Serum Institute of India, was recommended by the WHO last month and is now in a prequalification process, which leads to procurement and delivery. A decision is expected within months. It is likely to become available to African countries in the middle of next year.
“As a malaria researcher, I used to dream of the day when we would have a safe and effective vaccine against malaria,” Dr. Tedros said last month. “Now, we have two.”
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Trials of R21 have found that it reduced malaria cases by 75 per cent in the year following a three-dose series of the vaccine.
“The R21 vaccine is a vital additional tool to protect more children faster and to bring us closer to our vision of a malaria-free world,” Dr. Tedros said.
The R21 vaccine costs about US$2 to US$4 per dose, while the RTS,S vaccine is somewhat more expensive. The cost for African countries, however, will be financed by Gavi, a program of public and private donors, including UN agencies, governments, the World Bank and others.
Geoffrey York