On Wednesday, the World Health Organisation (WHO) recommended the widespread use of the only approved vaccine against malaria, and said it should be widely given to African children.
Malaria kills more than 400,000 people a year, most of them under the age of five.
The RTS,S malaria vaccine – or Mosquirix – has been developed by British pharmaceutical giant GSK, and its roll-out marks a major advance against a disease that evades the immune system.
Children in sub-Saharan Africa and in other regions with moderate to high levels of malaria transmission are to receive the vaccine.
How deadly is malaria?
Malaria is a preventable disease caused by parasites transmitted to people by the bites of infected mosquitoes. Symptoms include fever, vomiting and fatigue.
It killed 386,000 Africans in 2019, according to a WHO estimate, compared with 212,000 confirmed deaths from Covid-19 in the past 18 months.
WHO says 94% of malaria cases and deaths occur in Africa, a continent of 1.3 billion people.
What has been happening?
Since 2019, 2.3 million doses of Mosquirix have been administered to infants in Ghana, Kenya and Malawi in a large-scale pilot programme coordinated by the WHO. The majority of those whom the disease kills are aged under five.
That programme followed a decade of clinical trials in seven African countries.
So far, Mosquirix is the only approved vaccine. The European Union’s drugs regulator gave it the go-ahead in 2015, saying its benefits outweighed the risks
How does it work?
The jab requires four doses to be given to children aged five months and older.
The vaccine’s effectiveness at preventing severe cases of malaria in children is only around 30%. But health experts say that used in combination with other preventative measures – including bed nets and spraying – the vaccine could save “millions” of lives.
GSK said that when the jab is given in combination with seasonal administration of antimalarial drugs, the vaccine “lowers clinical episodes of malaria, hospital admissions with severe malaria, and deaths by around 70%”.
Another vaccine against malaria, developed by scientists at the University of Oxford and called R21/Matrix-M, showed up to 77% efficacy in a year-long study involving 450 children in Burkina Faso, researchers said in April, but it is still in the trial stages.
Any problems?
Experts said the challenge now would be mobilising financing for production and distribution of the vaccine to some of the world’s poorest countries.
GSK has to date committed to produce 15 million doses of Mosquirix annually, in addition to the 10 million doses donated to the WHO pilot programmes, up to 2028 at no more than 5% above the cost of production.
A study led by the WHO this year projected demand for a malaria vaccine would be 50 to 110 million doses per year by 2030 if it is deployed in areas with moderate to high transmission of the disease.
The Gavi vaccine alliance, a global public-private partnership, will consider in December whether and how to finance the vaccination programme.
What are people saying?
WHO director-general Tedros Adhanom Ghebreyesus:
Ashley Birkett, who leads global malaria vaccine work at Path, a non-profit global health organisation that has funded the development of the vaccine with GSK and the three-country pilot:
Thomas Breuer, chief global health officer of GSK:
Gavi chief executive Dr Seth Berkley:
Professor Sir Brian Greenwood, from the London School of Hygiene and Tropical Medicine, who has played a pivotal role in malaria vaccination trials and research since the inception of the jab:
Dr. Rose Jalong’o, a vaccinology specialist at the Kenyan health ministry:
