Why Malaria Vaccine Breakthrough is a Win for an Africa Child.
When it comes to malaria, the value of a broad range of prevention efforts may be most visible in Kenya, where 70 percent of the country’s 46 million people are at risk.
It is in this east African nation that a variety of preventive measures, tailored to meet the widely divergent needs of local populations, have translated into major overall progress.
Malaria continues to be one of the world’s deadliest diseases. In the country, the disease is the main cause of death among children under the age of five years. As a result, the country is participating in several global initiatives to reduce mortality rates.
According to the WHO’s World Malaria Report 2018, there has been no significant progress in reducing global malaria cases between 2015 and 2017.
In 2017, an estimated 219 million cases of malaria occurred worldwide, most of them (92%) in the WHO African Region. Of these cases, 435,000 patients died, again most of them (93%) in the WHO African Region. Children under 5 years are still the most vulnerable.
Under-five mortality still remains a major public health problem in sub-Saharan Africa (SSA). Of the 8.8 million global annual under-five deaths, about 50 percent occur in SSA.
In Kenya, one in twelve children (84 per 1000 live births) dies before their fifth birthday.
The coastal areas near the Indian Ocean and the Lake Victoria region, for example, are high-burden, and malaria prevalence hovers around 8 percent and 27 percent respectively.
Here insecticide-treated bednets are the primary preventive tool whereas indoor spraying with insecticides is targeted towards selected areas with high transmission around Lake Victoria.
However, the news of a vaccine breakthrough offers a ray of hope for millions of children in sub-Saharan Africa.
The Kenyan government was one of three African countries that piloted the world's first malaria vaccine, called RTS,S, in 2019.
Malaria, caused by a parasite spread by the bites of infected mosquitoes, is responsible for more than 400,000 deaths a year, most of them in young children in sub-Saharan Africa. It is chiefly tackled by people using insecticide-treated bed nets and drug treatments to reduce spread.
The news has been received with excitement in Africa which accounted for 94 percent of the world's malaria cases in 2019 with an estimated 215 million cases, according to the WHO World Malaria Report 2020.
RTS,S is given in 4 doses to young children (the first three before their first birthday and the last one around their second birthday). Adverse reactions were similar to those of other childhood vaccines. Side effects included pain and swelling at the injection side, with occasional seizures in febrile children. However, all children who suffered from febrile seizures made full recoveries.
Trials have shown that using the vaccine leads to a 30 per cent fall in cases of severe or deadly malaria even in areas where bed nets are widely used, according to the WHO.
This effectiveness is lower than vaccines against other diseases – for instance, the effectiveness of some covid-19 vaccines against severe disease range from 60 to 90 per cent.
The latest trials also found that families who had their children vaccinated continued to use bed nets, and that the vaccine is cost-effective.
This therefore requires that any malaria vaccine will need to join, and not replace the existing malaria control efforts that have been made so far, such as long-lasting insecticide-treated nets (LLIN), intermittent preventive therapy for pregnant women, proper sanitation and the application of residual insecticide, must be sustained and improved.
We just need the right framework, partnership and political goodwill at the country and regional level to step up the fight against the pandemic.