A highly effective malaria vaccine has been recommended for widespread use by the World Health Organization.
The R21/Matrix-M vaccine, developed by the University of Oxford, is only the second malaria vaccine to be recommended by the WHO. It is the first to meet the WHO’s target of 75% efficacy.
Malaria, a mosquito-borne disease, claims half a million lives every year and mostly affects children under the age of five, and pregnant women.
“As a malaria researcher, I used to dream of the day we would have a safe and effective vaccine against malaria. Now we have two,” said Dr Tedros Adhanom Ghebreyesus, director general of the WHO.
Demand for vaccines is huge. However, available supplies of the RTS,S vaccine, the first malaria vaccine approved by the WHO in 2021, are limited. A second WHO-recommended vaccine is expected “to protect more children faster, and to bring us closer to our vision of a malaria-free future,” said Tedros.
The world’s largest vaccine manufacturer by doses – the Serum Institute of India – is already lined up to make more than 100m doses a year and plans to scale up to 200m a year, the BBC reported. Each dose costs between $2 and $4; four doses are needed per person. That is about half the price of RTS,S. So far, there are only 18m doses of RTS,S.
Dr Matshidiso Moeti, the WHO’s regional director for Africa, said: “This second vaccine holds real potential to close the huge demand-and-supply gap. Delivered to scale and rolled out widely, the two vaccines can help bolster malaria prevention and control efforts, and save hundreds of thousands of young lives in Africa from this deadly disease.”
At least 28 countries in Africa plan to introduce a WHO-recommended malaria vaccine as part of their national immunisation programmes. Gavi, the Vaccine Alliance, has approved providing support to roll out malaria vaccines to 18 countries. The RTS,S vaccine will be available in some African countries in early 2024 and the R21 malaria vaccine is expected to become available to countries in mid-2024, according to the WHO.
Observers heralded the announcement, but warned the vaccine was “no magic bullet” in the fight against malaria and that it should be used in tandem with other measures, such as insecticide-treated nets and indoor spraying to prevent the disease.
Dr Michael Charles, the chief executive of the RBM Partnership to End Malaria, said the announcement was “a step in the right direction” but that there were still “major hurdles to overcome”.
“In the face of significant funding shortfalls and the growing threats of insecticide and drug resistance, and climate change, further investment must be urgently mobilised to scale up, manufacture and roll out malaria vaccines to ensure they are readily accessible to countries that decide to use them,” he said.
Gareth Jenkins, the executive director of advocacy and strategy at Malaria No More UK, said: “The reality is that malaria financing globally is far from where it needs to be and annual deaths from malaria rose during the pandemic and are still above pre-pandemic levels, so we cannot afford to be complacent as new tools are developed.”
Megan Greischar, an assistant professor of ecology and evolutionary biology at Cornell University, who studies parasites and the transmission of infection, said eliminating vector-born diseases such as malaria is incredibly difficult even with an effective vaccine.
“The current and new malaria vaccines face many hurdles, including multiple doses required to achieve protection. Vaccines will not, on their own, meet the goal of malaria elimination, except perhaps in places like the US where transmission is already rare. In areas where malaria is common, evolution – both of insecticide resistance in mosquitoes and drug resistance in malaria parasites – continues to erode public health gains by making existing tools less effective,” she said.
