WHO recommends breakthrough malaria vaccine for children at risk

The World Health Organization (WHO) recommends the widespread use of the malaria vaccine RTS, S / AS01 (RTS, S) in children in sub-Saharan Africa and other regions in Africa. P. falciparum transmission of malaria. The recommendation is based on the results of an ongoing pilot program in Ghana, Kenya and Malawi that has reached over 800,000 children since 2019.

“This is a historic moment. The long-awaited malaria vaccine for children is a breakthrough for science, children’s health and the fight against malaria, ”said WHO Director-General, Dr Tedros Adhanom Ghebreyesus. “Using this vaccine in addition to existing tools to prevent malaria could save tens of thousands of young lives every year.”

Malaria remains one of the leading causes of childhood illness and death in sub-Saharan Africa. More than 260,000 African children under five die of malaria each year.

In recent years, WHO and its partners have reported stagnant progress against this deadly disease.

“For centuries, malaria has stalked sub-Saharan Africa, causing immense personal suffering,” said Dr Matshidiso Moeti, WHO Regional Director for Africa. “We have long hoped for an effective vaccine against malaria and now, for the first time, we have such a vaccine recommended for widespread use. Today’s recommendation offers a beacon of hope for the continent that bears the heaviest burden of disease and we expect many more African children to be protected from malaria and grow into healthy adults.

WHO recommendation for the malaria vaccine RTS, S

Based on the advice of two WHO global advisory bodies, one for immunization and the other for malaria, the Organization recommends that:

WHO recommends that, as part of a comprehensive fight against malaria, the malaria vaccine RTS, S / AS01 be used for the prevention of malaria. P. falciparum malaria in children living in areas of moderate to high transmission as defined by WHO. RTS, S / AS01 malaria vaccine should be given on a 4-dose schedule in children from 5 months of age to reduce the disease and burden of malaria.

Summary of the main findings of the malaria vaccine pilot projects

The main findings of the pilot projects informed the recommendation based on data and information generated by two years of immunization at child health clinics in the three pilot countries, implemented under the leadership of the ministries of health of Ghana, Kenya. and Malawi. The results include:

• Possibility of delivery: Vaccine introduction is feasible, improves health and saves lives, with good and equitable coverage of RTS, S seen through routine immunization systems. This has happened even in the context of the COVID-19 pandemic.
• Reach out to the excluded: RTS, S increases equity in access to malaria prevention.
  • Data from the pilot program showed that more than two-thirds of children in the 3 countries who do not sleep under a net are receiving the RTS, S vaccine.
  • By superimposing the tools, more than 90% of the children benefit from at least one preventive intervention (mosquito nets impregnated with insecticide or vaccine against malaria).
• Strong security profile: To date, over 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 bed net use, other childhood vaccinations or febrile illness-seeking behavior. In areas where the vaccine has been introduced, there has been no decrease in the use of insecticide-treated mosquito nets, adoption of other childhood vaccinations or health-seeking behaviors for febrile illnesses. .
  
• High impact in real contexts of childhood immunization: Significant reduction (30%) in fatal severe malaria, even when introduced to areas where insecticide-treated bednets are widely used and where there is good access to diagnosis and treatment.
• Very profitable: Modeling considers the vaccine to be cost-effective in areas of moderate to high malaria transmission.

Next steps for the WHO recommended malaria vaccine will include funding decisions from the global health community for wider deployment, and country decision making on whether to adopt the vaccine as part of the national malaria control strategies.

Financial aid

Funding for the pilot program was mobilized through an unprecedented collaboration between three major global health funding agencies: Gavi, the Vaccine Alliance; the Global Fund to Fight AIDS, Tuberculosis and Malaria; and Unitaid.

Note to editors:

• The malaria vaccine, RTS, S, works against P. falciparum, the world’s deadliest malaria parasite and the most common in Africa.
• The malaria vaccine implementation program generates evidence and experience on the feasibility, impact and safety of the RTS, S malaria vaccine in actual routine situations in selected regions of Ghana, Kenya and from Malawi.
• Pilot introductions of malaria vaccines are led by the ministries of health of Ghana, Kenya and Malawi.
• The pilot program will continue in the 3 pilot countries to understand the added value of the 4^e vaccine dose and measure the longer-term impact on child deaths.
• The malaria vaccine implementation program is coordinated by WHO and supported by national and international partners including PATH, UNICEF and GSK, which is donating up to 10 million doses of vaccine for the pilot project .
• The RTS, S malaria vaccine is the result of 30 years of research and development by GSK and through a partnership with PATH, with the support of a network of African research centers.
• The Bill & Melinda Gates Foundation provided catalytic funding for the advanced development of RTS, S between 2001 and 2015.