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Children across much of Africa must be vaccinated against malaria at a historic moment in the fight against this deadly disease.
Malaria has been one of the greatest plagues of mankind for millennia and primarily kills babies and infants.
Having a vaccine – after more than a century of testing – is one of medicine’s greatest achievements.
The vaccine – called RTS, S – was found to be effective six years ago.
Today, following the success of pilot immunization programs in Ghana, Kenya and Malawi, the World Health Organization said the vaccine should be rolled out across sub-Saharan Africa and other areas where the transmission of malaria is moderate to high.
WHO Director-General Dr Tedros Adhanom Ghebreyesus said it was “a historic moment”.
“The long-awaited malaria vaccine for children is a breakthrough for science, children’s health and the fight against malaria,” he said. “[It] could save tens of thousands of young lives every year.
Deadly parasite
Malaria is a parasite that invades and destroys our blood cells to reproduce, and is spread by the bite of blood-sucking mosquitoes.
Medicines to kill the parasite, mosquito nets to prevent bites, and insecticides to kill the mosquito have all helped reduce malaria.
But the greatest burden of the disease is felt in Africa, where more than 260,000 children died from the disease in 2019.
It takes years of repeated infections to build immunity and even that only reduces the chances of getting seriously ill.
Dr Kwame Amponsa-Achiano piloted the vaccine in Ghana to assess whether mass vaccination was feasible and effective.
“It’s a pretty exciting time for us, with large scale vaccination, I think the malaria toll will be reduced to the bare minimum,” he said.
Constantly catching malaria as a child inspired Dr Amponsa-Achiano to become a doctor in Ghana.
“It was distressing, almost every week you weren’t in school malaria has been wreaking havoc on us for a long time,” he told me.
Save children’s lives
There are over 100 types of malaria parasites. The RTS, S vaccine targets the deadliest and most widespread in Africa: Plasmodium falciparum.
Trials, reported in 2015, showed that the vaccine could prevent about four in 10 cases of malaria, three in 10 severe cases and drop by a third the number of children needing blood transfusions.
However, there were doubts the vaccine would work in the real world as it requires four doses to be effective. The first three are given one month apart at five, six and seven months, and a last booster is needed around 18 months.
The results of the pilots were discussed Wednesday by two expert advisory groups at WHO.
The results, over more than 2.3 million doses, showed:
- the vaccine was safe and again led to a 30% reduction in severe malaria
- it has reached more than two-thirds of children who do not have a mosquito net to sleep under
- there was no negative impact on other routine vaccines or other malaria prevention measures
- the vaccine was cost effective
“From a scientific point of view this is a massive breakthrough, from a public health point of view it is a historic achievement,” said Dr Pedro Alonso, director of the Global Malaria Control Program. WHO.
“We have been researching a malaria vaccine for over 100 years now that will save lives and prevent disease in African children.”
Why is malaria so hard to beat?
After watching the world develop Covid vaccines in record time, you might be wondering why it took so long with malaria?
Malaria is caused by a much more insidious and sophisticated parasite than the virus that causes Covid. Comparing them is like comparing a person and a cabbage.
The malaria parasite evolved to escape our immune system. This is why you need to catch malaria many times before you start to get even limited protection.
It has a complicated life cycle between two species (humans and mosquitoes), and even inside our body it changes between different forms as it infects liver cells and red blood cells.
Developing a malaria vaccine is like nailing jelly to a wall and RTS, S can only target the sporozoite form of the parasite (this is the step between a mosquito bite and the arrival of the parasite in the liver).
This is why the vaccine is “only” 40% effective. However, this remains a remarkable success and paves the way for the development of even more potent vaccines.
The vaccine, developed by pharmaceutical giant GSK, will not replace all other malaria control measures such as insecticide-treated mosquito nets. It will be used alongside them to move closer to the goal of zero malaria deaths.
And it will not be used outside of Africa where the different forms of malaria, which the vaccine cannot protect, are more prevalent.
Dr Ashley Birkett, of the Path Malaria Vaccination Initiative, said the vaccine rollout was a “historic event” that would “remove fear” from families.
He said to me, “Imagine your young child might one day be healthy and full of potential, then after being bitten by an infected mosquito, playing with friends or sleeping in a bed, he might die in a bed. a few weeks.
“Malaria is a huge problem, it’s scary and frightening.
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