First mass malaria vaccination campaign begins in Africa

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The first malaria vaccination campaign for children backed by the World Health Organization begins in Africa on Monday, with the distribution of nearly 30mn jabs in the coming months marking a milestone in the fight against the tropical disease.

Children in Cameroon will begin receiving malaria vaccines as part of a rollout of the medicine developed by UK pharmaceutical company GSK in up to 12 countries across sub-Saharan Africa. A second vaccination developed by scientists at Oxford university and produced by the Serum Institute of India is set to be delivered in seven countries in May or June.

The distribution of an initial 18mn doses marks a significant turning point in the fight against malaria, a preventable disease caused by parasites transmitted by mosquitoes that killed 608,000 people — 95 per cent of them in Africa — in 2022.

“The vaccination will save lives, it will provide major relief for families and the country’s health system and it will also be yielding important economic dividends,” said Aurélia Nguyen, chief programme officer at Gavi, the global vaccine alliance that is working with African countries to co-ordinate the rollout.

Children under the age of five are particularly vulnerable to the disease. GSK’s RTS, S vaccine has already been rolled out to nearly 2mn children in Ghana, Kenya and Malawi as part of a pilot programme, with WHO studies showing a 30 per cent reduction in severe malaria symptoms.

More than 30 countries across the continent have expressed an interest in receiving malaria jabs. Up to 18mn doses of the RTS, S vaccine are being distributed by Gavi, followed by an estimated 10mn doses of the R21/Matrix-M jab across seven countries in mid-2024.

The WHO first recommended the GSK shot in 2021 for widespread use. In October, the WHO also gave its backing to the Oxford vaccine.

The plan faces logistical challenges. Children will need four shots within two years of their birth, presenting logistical challenges for health teams to reach families in remote areas. Health leaders hope to line up malaria vaccinations with other shots — such as for measles — to help increase take-up of all four doses.

“When children come for other vaccine appointments, they are given their malaria vaccine. There are challenges in areas where children cannot be reached and [we need] community strategies to make sure children keep coming back,” said Dorothy Achu, regional malaria adviser for the WHO.

Adrian Hill, one of the Oxford scientists behind the R21 jab, criticised the WHO for a lack of “urgency” after the body targeted mid-2024 for the distribution of the jab.

Oxford’s partnership with the Serum Institute of India, the world’s largest vaccine maker, allows production of its shot on a much bigger scale than GSK. The SII said late last year that it had produced 20mn doses and “already” had capacity to produce 100mn shots a year.

But Nguyen reiterated the mid-year target, saying the R21 vaccine was in an early stage of manufacturing and would become available in May or June.

She added that there is a need for continued innovation: “These are two really good vaccines. We want to make sure that vaccines keep getting developed to the point of having perhaps less doses on the schedule, pushing forward on affordability and ease of use.”

Additional reporting by Donato Paolo Mancini