Malawi has become the first country in the world to launch a landmark malaria vaccine in what the World Health Organization is hailing as a historic moment in the fight against the disease.
The vaccine, called RTS,S, has been in development for 30 years and is being made available as part of a pilot programme funded by three organisations: Gavi, the Vaccine Alliance, the Global Fund to Fight Aids, Tuberculosis and Malaria and Unitaid.
The pilot programme will also be launched in Ghana and Kenya in the coming weeks with around 360,000 children every year across the three countries receiving the vaccine.
Malaria remains one of the world’s leading killers, claiming the life of one child every two minutes. Most of these deaths are in Africa, where more than 250,000 children die from the disease every year. Children under the age of five are at greatest risk of its life-threatening complications. Worldwide, malaria kills 435,000 people a year, most of them children.
In clinical trials the vaccine was shown to prevent four out of 10 cases of malaria and, because the results were not as strong as had been hoped, WHO decided to launch a pilot programme to evaluate its effectiveness.
The pilot programme, which will last two years, is designed to generate evidence and experience to inform WHO policy recommendations on the broader use of the vaccine.
It will look at reductions in child deaths and cases; vaccine uptake, including whether parents bring their children on time for the four required doses; vaccine safety; and value for money
WHO’s expert committees on immunisation and malaria will consider the evidence of the pilot programme and WHO is committed to following the “path of evidence”, said Professor Kate O’Brien, director of the organisation’s department of immunisation, vaccines and biologicals.
The vaccine, developed by UK drug firm GSK, has to be given in four doses: children receive three doses between the ages of five and nine months and a booster dose at their second birthday.
Pedro Alonso, director of WHO’s global malaria programme, said the launch in Malawi was a “historical moment in the very very long fight against malaria”.
He conceded that the vaccine was “imperfect” but, when used on a large scale, he said it had the potential to avert millions of cases of the disease and thousands of deaths.
“With malaria we need to use everything we have at hand. We cannot afford not to use everything we have therefore we are incredibly excited about the launch of the first malaria vaccine being deployed in Africa through routine use,” he said.
Dr Alonso said that when insecticide-treated bed nets were launched they were met with scepticism because they too only averted four out of 10 cases.
“But data showed they could have a massive impact and they have become a cornerstone of efforts to fight the disease,” he said.
Prof O’Brien said that the introduction of the vaccine was a milestone in the fight against the disease.
She added: “It’s an imperfect vaccine against a complex disease. But it has significant potential to save lives and deliver on the health aspirations we have for all children around the world.”
RTS,S, first developed in 1987 by GSK, aims to trigger the immune system to defend against the first stages of malaria when the Plasmodium falciparum parasite enters the human host’s bloodstream through a mosquito bite.
The vaccine is designed to prevent the parasite from infecting the liver, where it can mature, multiply, reenter the bloodstream, and infect red blood cells, which can lead to disease symptoms.
Thomas Breuer, chief medical officer of GSK Vaccines, said: “Delivering the world’s first malaria vaccine will help reduce the burden of one of the most pressing health challenges globally. This novel tool is the result of GSK employees collaborating with their partners, applying the latest in vaccine science to contribute to the fight against malaria.”
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