The world’s first malaria vaccine has been approved for widespread use in children living in regions where malaria transmission is moderate to high. The RTS,S/ASo1 vaccine, also known as Mosquirix, significantly reduces the incidence of malaria and severe malaria that predominantly affects children aged younger than five years. The RTS,S vaccine consists of a part of the parasitic protein bound to part of a hepatitis B viral protein. The vaccine should be administered in a four-dose schedule to children aged older than five months. After almost 40 years of research and development, the World Health Organisation’s (Who) endorsement of this vaccine marks a major public health milestone—signalling renewed prospects for malaria control efforts.
Malaria is an acute febrile illness caused by infection with the Plasmodium parasite. The disease kills more than 400,000 people a year, with the majority of deaths disproportionately concentrated amongst young children in the Africa region. GlobalData epidemiologists forecast that in the six major markets alone—the Democratic Republic of the Congo, Ghana, Kenya, Nigeria, India and Indonesia—there are estimated to be 107 million new infections and more than 190,000 deaths this year. In addition, the number of new infections and deaths is expected to continue climbing over the coming years. But with the use of this vaccine in addition to existing tools, many malaria-endemic countries face the opportunity for reduced malarial illness and deaths in the future.
The WHO recommendation follows findings from a pilot program with more than 800,000 children in Kenya, Ghana and Malawi. The trial showed that the vaccine not only had a strong safety profile, was cost-effective and feasible to deliver, but also yielded a 30% reduction in cases of severe malaria. These findings finally addressed long-standing challenges surrounding the feasibility of this vaccine rollout in the public health community.
In addition, a study led by the London School of Hygiene and Tropical Medicine (LSHTM) found children who were given the RTS,S vaccine and antimalarial drugs showed a 70% reduction in hospitalisation and mortality, compared to children who did not have the vaccine. It is estimated that for every 200 children vaccinated, one life is saved. On a widescale basis, this presents the opportunity to save many thousands of lives in addition to the positive health, economic and social consequences for affected countries.