WHO launches malaria vaccine program in 3 African countries

WHO has launched a pilot program that aims to immunize around 360,000 children each year in three African countries with the first and only vaccine shown to significantly reduce malaria in children.

The Malaria Vaccine Implementation Program began today in Malawi. The vaccine, called RTS,S (GlaxoSmithKline), also will be deployed in Ghana starting next week, followed closely by Kenya, officials announced.

“This is a landmark moment for immunization and public health,” Kate O’Brien, MD, director of WHO’s Department of Immunization, Vaccines and Biologicals, said in a news conference.

The vaccination program was initially announced in 2017 in advance of World Malaria Day.

“The pilot programs are expected to continue for the next 4 years,” O’Brien added.

Illness and deaths related to malaria remain high in some areas, even with the use of “disease-cutting tools,” such as insecticide-treated mosquito nets, indoor insecticides and antimalarial medicines. Specifically, more than 90% of the global disease burden is situated in Africa. According to the CDC, malaria caused approximately 216 million illnesses worldwide in 2016, resulting in 445,000 deaths. Most of those cases were children in sub-Saharan Africa, the agency said.

With help from PATH’s Malaria Vaccine Initiative, RTS,S was developed by GSK over 3 decades and many studies have evaluated the vaccine’s safety and efficacy.

“For PATH, this has been a nearly 20-year journey,” Deborah Atherly, PhD, who directs PATH’s vaccine access and introduction activities, said in the news conference. “We’ve helped see this vaccine through clinical development and had the extreme fortune to have had the opportunity to work with researchers and communities across Africa and with GSK to help bring RTS,S to this point.”

According to WHO, RTS,S provides partial protection against malaria in young children and is the only malaria vaccine to demonstrate a protective effect against the disease.

“This vaccine, as much of a milestone as it is, it is an imperfect vaccine against a complex disease,” O’Brien said.

Results from a 5-year phase 3 trial conducted among approximately 15,000 young children and infants in seven sub-Saharan African countries showed that the vaccine prevented 39% of malaria cases and 29% of severe malaria cases, according to WHO.

“We believe that this may yet another tool, an imperfect tool with varied efficacy just like all of our other malaria control tools, which used routinely may actually have massive impact and help us get back on track to our ultimate goal of seeing a world free of malaria,” Pedro L. Alonso, MD, PhD, director of WHO’s Global Malaria Programme, said.

PAGE BREAK

According to WHO, children in select areas in the three countries will receive four doses of the vaccine: the first three between age 5 and 9 months, and the fourth dose around age 2 years.

“There are evaluation partners in each of the three countries and they will evaluate vaccine introduction in the context of routine use,” Mary Hamel, MD, senior technical officer for the Malaria Vaccine Implementation Program, said. “These evaluation partners measure whether children receive the four vaccine doses required for ultimate benefit. They will look at the reduction in child death in areas where the vaccine is introduced, and they’ll look at safety in routine use.”

The pilot program is coordinated by WHO in collaboration with the health ministries in Ghana, Kenya and Malawi; GSK, PATH and other international partners. It is being financed by Gavi, the Vaccine Alliance; the Global Fund to Fight AIDS, Tuberculosis and Malaria; and Unitaid.

“I’d like to highlight the leadership of the African countries,” O’Brien said. “It really has been their push, their leadership, their recognition of this as a priority for their health programs and their immunization programs in their fight against malaria.

“Vaccines are such a central part of the opportunity for people of all ages to live a healthy life and [are] a universal right.” – by Marley Ghizzone

References:

CDC. Malaria's Impact Worldwide. https://www.cdc.gov/malaria/malaria_worldwide/impact.html. Accessed April 22, 2019.

mviPATH. RTS,S; Ghana, Kenya, and Malawi to take part in WHO malaria vaccine pilot programme. https://www.malariavaccine.org/malaria-and-vaccines/first-generation-vaccine/rtss. Accessed April 22, 2019.

WHO. First malaria vaccine in Africa: A potential new tool for child health and improved malaria control. https://apps.who.int/iris/bitstream/handle/10665/272456/WHO-CDS-GMP-2018.05-eng.pdf?ua=1. Accessed April 22, 2019.

WHO. Short overview of the malaria vaccine implementation programme. https://www.who.int/malaria/media/malaria-vaccine-overview/en/. Accessed April 22, 2019.

WHO. Q&A on the malaria vaccine implementation programme (MVIP). https://www.who.int/malaria/media/malaria-vaccine-implementation-qa/en/. Accessed April 22, 2019.

Disclosures: Alfonso, Hamel and O’Brien are employed by WHO. Atherly is employed by PATH.