The efforts to eliminate malaria disease have received a major boost following the official launch of routine malaria vaccination in Africa with Cameroon becoming the first country to do so.
In November 2023, Cameroon received over 330,000 doses of the World Health Organization (WHO) approved RTS, S vaccine from Gavi, the Vaccine Alliance, with an additional over 650,000 doses to be delivered in 2024.
The malaria vaccines will be administered, in a four-dose schedule, to all children aged between five months and five years. It will be given to children across the 42 malaria-endemic districts in Cameroon. However, experts say that five jabs are possible for children residing in countries with seasonal transmission where the risk remains high after the fourth jab.
Cameroon is one of the countries where malaria cases have been rising since 2017. The disease accounts for nearly half of all hospitalizations among children below five years in the country.
Africa shoulders the biggest burden of global malaria cases and deaths. The continent accounted for 94% and 95% of global malaria cases and deaths respectively in 2021, with six Member States alone carrying nearly half of the burden worldwide.
Speaking during an online press briefing on the start of routine malaria vaccinations in Africa, Aurélia Nguyen, Chief Programme Officer, Gavi noted: “The malaria vaccines offer a new control component in the fight against malaria, a disease that has impacted Africa disproportionately. The vaccine is going to be available for all children who come to the clinics. It will save lives, provide relief to families and the country’s health system, and yield important economic dividends.”
The malaria vaccine will be rolled out as part of routine expanded programmes on immunization (EPI) so that when children come for the other vaccine appointments, they also get the malaria vaccine.
Across Africa, 30 countries have planned to introduce malaria vaccines in their routine immunization programs, seven of which have already received certain doses and are making preparations for launch.
“Today marks a historic milestone in our enduring fight against malaria, a disease that has plagued Africa with severe health and economic consequences. The RTS,S vaccine has been validated through rigorous trials and it has proven to reduce mortality and morbidity associated with malaria. The impact of this vaccine goes beyond the medical benefits. It is a crucial element in improving African children’s educational outcomes and cognitive ability,” said Dr Mohammed Abdulaziz, Head of Disease Control and Prevention, Africa CDC.
“Beginning with Cameroon, the malaria vaccine will be rolled out more broadly across the continent as part of routine services. The scale-up of malaria vaccine for immunization is expected to save tens of thousands of lives each year. The vaccine has been shown to reduce clinical malaria cases by more than half in the year after vaccination and that level of efficacy goes up when the vaccine is provided seasonally,” noted Kate O’Brien- Director, WHO’s Department of Immunization, Vaccines and Biologicals.
O’Brien stressed the importance of using the vaccines in combination with other malaria prevention and control measures such as treated bed nets and indoor spraying.
“We won’t see the progress that we are hoping to get through the vaccine if we are trading off other prevention for the vaccine. Moreover, the highest impact is seen when malaria prevention tools are used together. No one intervention for malaria is going to be that one thing that a family needs to do. It is about adding all of them together,” she added.
Dr Dorothy Achu- Regional Malaria Adviser, WHO Regional Office for Africa pointed out that: “The introduction of these malaria vaccines into the malaria toolbox presents a great opportunity to accelerate the reduction of malaria mortality and morbidity in Africa by combining the vaccines with existing tools.”
Andrew Jones, Principal Advisor at UNICEF also shared similar sentiments adding that: “The malaria vaccines are going to help save more children from the deadly disease. The fact that there are now two pre-qualified vaccines is a major step towards accelerating supply. Every child with a risk of malaria must receive vaccines. This is a giant step forward in our collective efforts to save children’s lives and reduce the burden of malaria.”
The R21 vaccine is the second malaria vaccine recommended by WHO, following the RTS,S vaccine, which received a WHO recommendation in 2021.
Both vaccines, according to WHO, are safe and effective in preventing malaria in children and, when implemented broadly, are expected to have a high public health impact.