The first-ever malaria vaccine has been introduced in Malawi, targeting children under two years of age. Known commercially as Mosquirix, the RTS,S/AS01 vaccine aims to combat P. falciparum, a prevalent malaria strain in Africa. This vaccine is the first to showcase partial protection for young children, with clinical trials indicating that it prevents approximately 40% of malaria cases, including 30% of severe instances.
This ground-breaking initiative is coordinated by the World Health Organization (WHO), assisted by ministries of health from Malawi, Kenya, and Ghana. This program also brings together diverse international partners, among which include PATH, a non-profit organization, and GSK, the creator and supplier of the vaccine. GSK has generously pledged up to ten million vaccine doses for this pilot project.
About PATH: The International Non-profit Team
PATH, an international, non-profit organization, marries innovation with collaboration to manage pressing global health issues such as malaria. PATH partners with various entities, including public institutions, businesses, grassroots groups, and investors, to effect positive change worldwide. The malaria vaccination scheme seeks to extend its reach to around 360,000 children annually across the three African nations.
World Bank’s World Malaria Report, 2018
According to the World Malaria Report published by the World Bank in 2018, malaria is present in 91 countries, but about 90% of the cases and deaths occur in sub-Saharan Africa.
| Country | Number of Cases | Percentage Share |
|---|---|---|
| Sub-Saharan Africa | ~90% cases | 90% |
| Other Countries | ~10% cases | 10% |
Mechanism of RTS,S
The RTS,S vaccine prompts the immune system to defend against early-stage malaria contracted through a mosquito bite, thereby preventing the P. falciparum parasite from infecting the liver cells. The primary aim of the vaccine is to prevent the parasite from maturing in, and reentering from, the liver into the bloodstream, preventing red blood cells infection and subsequent disease symptoms.
Financing and Support: Global Health Bodies Collaborate
Three key global health funding bodies have pooled resources for this pilot project. These include the Vaccine Alliance, Gavi; the Global Fund to Fight AIDS, Tuberculosis and Malaria; and Unitaid. Additional support and in-kind contributions are provided by WHO, PATH and GSK.
Weaknesses of the New Vaccine
Despite its groundbreaking nature, the new vaccine has limitations. A child must receive four injections before age 2, at intervals that may not correspond with routine vaccine schedules. Furthermore, trial data indicates that even after the full course, the vaccine prevents only about 40% of detectable malaria infections. How long these low levels of protection last is still unclear as vaccinated children were followed only for four years in trials. There are also concerns about possible complacency towards other preventive measures, such as mosquito nets, among parents of vaccinated children. Lastly, there is a possibility of malaria parasites developing resistance to this vaccine over time.
Malaria in India
India ranks high among countries severely affected by malaria. In 2018 alone, 3,99,134 malaria cases and 85 deaths were reported according to the National Vector Borne Disease Control Programme.
About Malaria
Malaria is a mosquito-borne disease caused by Plasmodium parasites. These parasites are spread to humans through the bites of infected mosquitoes, particularly those belonging to the Anopheles genus. Of the more than 400 different Anopheles species, around 30 are significant malaria vectors.
P. falciparum, responsible for most global malaria-related deaths, and P. vivax, the dominant malaria parasite outside sub-Saharan Africa, pose the greatest risk. Most cases and deaths occur in sub-Saharan Africa but South-East Asia, Eastern Mediterranean, Western Pacific, and the Americas are also at risk. The WHO recommends protection with effective malaria vector control, primarily insecticide-treated mosquito nets and indoor residual spraying.
