Malawi silently pilots world’s first malaria vaccine for under 5 toddlers

Written by  Felix Mponda

Malawi - where malaria is the leading cause of morbidity and mortality in under 5 children, and is also one of the major health problems with six million episodes of malaria every year - on Tuesday silently piloted the world’s first malaria vaccine for under 5 toddlers.

A Malawian woman receives a net, one of the tools to prevent malaria. A Malawian woman receives a net, one of the tools to prevent malaria.

Across the country’s 11 of the 28 districts, the groundbreaking vaccine took off the ground targeting under-five children without any fan-fare nor official speeches.

“The malaria vaccine is being introduced as a pilot programme in routine immunization as an additional malaria control measure,” Bestone Chisamile, a top official in the Ministry of Health and Population, said in a statement published widely in local media.

Up to 120,000 children are being targeted in Malawi alone.

The districts where the introduction rolled off are two lakeshore districts of Karonga and Nkhata Bay in the north, inland districts of Ntchisi, Mchinji and Lilongwe rural in the centre, while Balaka, Machinga, Mangochi (partly lakeshore) , Phalombe, Chikwawa and Nsanje in the South make up the 11 districts.

Malaria, alongside pneumonia and diarrhea, is one of the top three causes of death among children under five years old and pregnant women.

Health experts say the fatalities are usually caused by people bringing their children to hospital too late. The disease is preventable and easily treatable if diagnosed early.

But RTS,S/ASOI vaccine, called Mosquirix, will also be introduced as a pilot programme in Ghana and Kenya.

Chisamile said the vaccine “is an injectable vaccine that reduces malaria episodes by close to 40 percent in young children and acts against Plasmodium jalciparum, the deadliest malaria parasite in Malawi and globally and the most common in Africa.”

The vaccine “is the first and to-date the only vaccine to show protective effect against malaria among young children in Phase 3 clinical trial,” Chisamile, said, adding that from April 23, it will be the first malaria vaccine provided to toddlers through a routine immunization programme.

Children will receive four doses of the vaccine by injection on the thigh, with the first dose given at five months of age, second at six months, third at seven months while the fourth and last will be administered at about 22 months.

“This malaria vaccine has shown a protective effect when a child received all four doses. Children who receive four doses and continue to use other malaria prevention measures have a significantly low risk of suffering from both mild and severe malaria,” he said.

The Ministry said the vaccine was a potential additional tool to complement the existing package of the World Health Organisation (WHO) recommended malaria control measures, including other preventative measures such as bed nets, insecticides, repellants and anti-malarial drugs.

“The Ministry would like to stress on the importance of continued use of all existing malaria control measures even if the child receives the malaria vaccination,” said the official, appealing to parents in the selected areas to take their off-springs to the under 5 clinics for vaccination.

A 2017 malaria indicator survey report indicated that 24 percent of children aged 6-59 months tested positive for malaria in Malawi.

The WHO says malaria, a mosquito-borne disease, killed 429,000 people worldwide in 2015,. About 92 percent victims were from Africa and two-thirds of them children under five.

Dr Matshidiso Moeti, the WHO's regional director for Africa, has said the prospect of a malaria vaccine was great news, adding that information gathered in the pilot will help “us make decisions on the wider use of this vaccine.”

"Combined with existing malaria interventions, such a vaccine would have the potential to save tens of thousands of lives in Africa," Moeti said in a statement.

British pharmaceutical giant GlaxoSmithKline (GSK) in partnership with the PATH Malaria Vaccine Initiative have developed the vaccine, and the large-scale three-country pilot will test it on children aged five to 17 months.

The trial aims to assess the effectiveness of the vaccine as well as the feasibility of its delivery to populations at risk as four successive doses must be given on a strict timetable.

Symptoms of malaria include fever, muscle pain and headache as well as vomiting and diarrhoea.

The three African states were selected for the trial because malaria rates are high and they have a long history of use of bed nets and other interventions.

Malaria remains one of the world’s most stubborn health challenges, infecting more than 200 million people every year and killing about half a million, most of them children, in Africa. Bed netting and insecticides are the chief protection.

Sub-Saharan Africa is hardest hit by the disease, with about 90% of the world’s cases in 2015. Malaria spreads when a mosquito bites someone already infected, sucks up blood and parasites, and then bites another person.

The WHO is hoping to wipe out malaria by 2040 despite increasing resistance problems to both drugs and insecticides used to kill mosquitoes.

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