By Olakunle Olafioye
The global war against malaria received a major boost with the World Health Organisation’s (WHO) recommendation of widespread use of the groundbreaking malaria vaccine for children, RTS,S/ASO1 (RTS,S) among children in sub-Saharan Africa and other regions with malaria transmission.
The world body had last month announced the recommendation of RTS,S from the over 100 malaria vaccines that are being developed.
The announcement ushered in renewed optimism in the battle against the disease which has remained one of the major killer diseases, especially in Sun-Saharan Africa.
A medical practitioner, Dr Olufunke Oseni, in a chat with Sunday Sun described the news of the discovery of the vaccine as one of the most exhilarating breakthroughs in recent years, expressing optimism that the vaccine would further accelerate the battle against malaria scourge in Africa.
“With the recommendation of this vaccine by the WHO Africa, Africans can now heave a sigh of relief from malaria especially among children. The discovery of this vaccine is one of the most exhilarating breakthroughs in the medical field in the recent years. I hope the Nigerian government will do everything within its powers to ensure the country keys into it in the overall interest of the people,” Dr Oseni said.
Malaria is caused by parasites that are transmitted to people through the bites of infected female anopheles mosquitoes.
And for decades, Malaria has remained a primary cause of childhood illness and death in sub-Saharan Africa. It is estimated that hundreds of thousands of African children under the age of five die from malaria annually.
But in 2015, WHO announced that the global incidence of malaria had finally been slowed. The world body had attributed the progress to a massive rollout of mosquito nets, anti-malaria medicines and indoor residual spraying of insecticides.
The news at the time was a morale booster in the battle against malaria particularly in Africa, where the disease has been the deadliest until last month when WHO announced the breakthrough of the landmark malaria vaccine.
Between 2000 and 2015, malaria mortality rate in Africa was said to have fallen by 66 per cent among all age groups. Among children under five, who are the most vulnerable to the disease fatalities, it was estimated to have fallen by 71 per cent, from 694,000 to 292,000 deaths, during the same period.
Progress in the use of mosquito nets has been impressive. WHO data shows that in 2000, just two per cent of the 667 million people living in sub-Saharan Africa at that time slept under mosquito nets. But by 2015, more than half of Africa’s one billion people were using bed nets.
With the latest development, experts are optimistic that hope for more accelerated progress in the fight against the malaria scourge is in the horizon.
A pharmacist, Silas Anele, said that the combination of a WHO-approved vaccine with the coordinated approach against malaria, holds more prospect in tackling the disease.
“I want to say that we are inching closer to achieving the dream of eliminating malaria because the RTS,S based on reports from the countries that have accessed it so far, has raised the confidence level in the fight against malaria,” he observed.
Reports of the vaccine have continued to give hope – boosting signals about its safety profile with an estimated 2.3 million children across three different countries believed to have been vaccinated with significant impact and with the report of reduction in deadly severe malaria.
The recommendation of the widespread use of the vaccine is said to have been informed by the results from an ongoing pilot programme in Ghana, Kenya and Malawi since 2019.
WHO Director General, Dr Tedros Adhanom Ghebreyesus, in a media report, was quoted to have described the breakthrough as historic.
“This is a historic moment. The long-awaited malaria vaccine for children is a breakthrough for science, child health and malaria control. Using this vaccine on top of existing tools to prevent malaria could save tens of thousands of young lives each year.”
In the last 20 years, reports put the rate of new vaccine trials at 10 per year. However, trial registrations is believed to be shifting priorities over time, but RTS,S studies have maintained consistent pace throughout albeit with large sample sizes, while trials that assess whole sporozoite vaccines (WSV) for their safety and efficacy to reduce P.falciparum infection episodes increased in frequency in the last decade.
The first vaccine candidates to protect women from placental malaria entered the clinic in the past five years, and trials of blood-stage vaccines (BVS) which target blood stage merozoites, with the potential to control blood-stage multiplication, or abort infection during the blood stage decreased in frequency from 2001-2010 to 2011-2020.
Interest has increased in the use of vaccines for malaria elimination, or a so-called vaccine to interrupt malaria transmission (VIMT), that could include antigens expressed during pre-erythrocytic, blood-stage and/or mosquito-sexual stage development in order to reduce or halt the spread of parasites in the community. P.vivax vaccine trials were registered sporadically, reflecting the dearth of resources dedicated to this neglected disease that afflicts millions each year. Notably, some promising P. vivax candidates induced functional activity in phase 1 trials.
But while medical experts are excited about the malaria vaccine breakthrough, some Nigerians have expressed fear over the acceptance of the vaccine among the citizens particularly with the country being one of the first set of countries where the vaccine is to be introduced.
But Mr. Anele is of the opinion that Nigerians have nothing to worry about over a vaccine that has the approval of the World Health Organisation.
He pointed out that the development of the vaccine, which he noted took several years of painstaking efforts, should be considered safe once it has the approval of a reputable global body like the WHO.
According to Anele, “the vaccine in question has been on trial in some countries in the continent since 2019 without any adverse report. The degree of success recorded in the pilot countries should therefore buoy the confidence of the people in the vaccine,” adding that health authorities in the nation’s health sector are equal to the task in educating and enlightening Nigerians about the safety and efficacy of the vaccine.
This view is shared by Dr. Oseni who opined that concerned health authorities in the country have demonstrated their competence over time in mobilizing Nigerians to show positive disposition towards such programme.
According to her, “the growing acceptance of COVID-19 vaccine among Nigerians despite the initial rumor and all manner of unfounded and unsubstantiated lies over the safety of the vaccine is an indication that our people’s eyes are being opened to the truth. All that is needed is sustained mobilization and enlightenment campaigns to ensure Nigerians embrace the vaccine once it is rolled out in the country.”
Barring any change of plans Nigeria will take delivery of the newly developed malaria vaccine before the end of the first quarter of next year.
The Assembly of Health Ministers of the ECOWAS region which made the announcement in Abuja penultimate Friday said that countries like Nigeria would support the West Africa region in the procurement of the vaccine.
According to the Health Minister of Ghana and Chairman of the assembly, Dr Kweku Agyeman Manu, who addressed newsmen at the 22nd ordinary session of health ministers in Abuja, the adoption and the rollout of the vaccine would commence as early as the first quarter of next year in the continent.