OMS recommends expanding use of malaria vaccine in Africa

The World Health Organisation (WHO) today recommended the wider use of a malaria vaccine used in three African countries participating in a pilot project that has been shown to be safe, although its efficacy is relatively low, and should be used in combination with existing prevention and diagnostic measures.

Called RTS,S, this vaccine is a historic milestone from a scientific and human point of view, since it is the first to have been developed by a platform of African scientists and because it is intended to prevent a disease that kills 94% of its victims in sub-Saharan Africa.

It is also the first to be developed against a parasite in humans.

"This vaccine has the potential to save tens of thousands of young lives. We have made incredible progress in the last two decades, malaria cases have fallen by half, but globally cases remain far too high, with 200 million cases annually and more than 400,000 deaths, said WHO Director-General Tedros Adhanom Ghebreyesus, announcing the vaccine recommendation.

Ghana, Malawi and Kenya are the three countries where the vaccine was introduced in 2019, with 2.3 million doses administered and 800,000 children having received at least one dose. "It is the best possible investment ever made in public health," said the director of WHO's Global Malaria Programme, Pedro Alonso.

Approval of the expanded use of the vaccine will allow it to be incorporated into the existing malaria control toolkit (insecticide-treated nets, prophylactic drugs, diagnostics and treatment), but will not replace any of them, experts said.

The pilot project in the three African countries has confirmed the feasibility of administering the four doses required for this vaccine, its role in reducing child deaths and that it can be integrated into national immunisation programmes without major complications.

It has also been shown that the availability of a vaccine has not led families living in endemic areas to neglect the use of mosquito nets, nor has it had a negative impact on the coverage of other vaccines for children.

Research has shown that the vaccine can reduce cases of severe malaria that can lead to death by 30%.

Expanding the use of the RTS,S vaccine will require new investments and today's WHO approval will allow the Vaccine Access Alliance (known as GAVI) to add the vaccine to its portfolio and consider investing in this product to provide access to the poorest countries.

This decision "opens the door for widespread use of this vaccine, which will save lives, prevent the disease among African children and hopefully also stimulate further research to try to develop other malaria vaccines. The one we have is a first generation vaccine, but it should not be the last," Alonso said.

The approved vaccine has been administered in regular vaccination programmes and has had a high level of acceptance and confidence from families in the three countries where it has been used, which explains why 80-90% of young children have received it, according to WHO data.

Of the 410,000 malaria deaths per year, 260,000 are among children under five years of age. 

Malaria, which is transmitted by a mosquito, can be contracted several times in a lifetime and studies indicate that when this occurs at an early age, children's development and future life can be severely compromised, which could be prevented with the recommended vaccine.