Following an announcement on Wednesday the 6th of October, the World Health Organization (W.H.O.) has endorsed the widespread rollout of the world’s first malaria vaccine. RTS,S – or Mosquirix – has been recommended following the success of a 2019 pilot programme in Ghana, Kenya, and Malawi. Developed by British pharmaceutical GlaxoSmithKline, the initial vaccine rollouts will target vulnerable children in sub-Saharan African (SSA) countries. They are particularly susceptible to the Plasmodium falciparum parasite that causes malaria. The approval of this vaccine marks a historic day in the battle against one of the world’s deadliest infectious diseases.
W.H.O. Director-General Dr Tedros Adhanom Ghebreyesus hailed this as “a historic moment.” On Twitter, Ghebreyesus said that “this vaccine is a gift to the world, but its value will be felt most in Africa because that’s where the burden of malaria is greatest.”
In a report with the BBC, Chulu Yebo of Zambia expressed their personal feelings to the news, stating that “the approval of the malaria vaccine has been long overdue. We can’t be having such diseases in the 21st Century… malaria… is a horrible disease, I have had it before. I feel very happy that the vaccine has been approved.”
Temperature, humidity, and rainfall all impact the distribution and seasonality of malaria, and SSA is notably affected as much of the continent’s tropical and subtropical climate is favourable to P. falciparum’s lifecycle. In 2019, there were an estimated 229 million malaria cases, and the estimated number of deaths that year stood at 409,000 – of which SSA represented 94 per cent of all cases and deaths.
In addition to the tragic human cost, many SSA economies have seriously suffered financially from this parasite. From the medical and household expenses of the individual to the strain on public health institutions, studies have estimated that malaria costs African economies U.S. $12 billion every year. The need to combat this threat is imperative.
Previous attempts to reduce transmission include improving the accuracy and speed of diagnostics and treatment, supplying bed nets to create a physical barrier, and the use of insecticides. However, the efficiency of these measures remains minimal in eradicating malaria. Laboratories have even used CRISPR to genetically engineer anti-malarial genes into mosquito species to reduce transmissions between the parasite and host. Yet the technology is extremely new, and as The Guardian reports, many fear that the “accidental release of modified organisms could have unpredictable ecological consequences.”
Mosquirix is especially ground-breaking; it is the first vaccine successfully developed for any parasitic disease. Compared to viral and bacterial pathogens, many parasites – including P. falciparum – are more complex as they efficiently manipulate our immune systems. According to Anja Joachim (2016), previous attempts to develop malarial immunity have been slow, incomplete, and insufficient in disrupting the parasite’s lifecycle.
Currently, the Mosquirix vaccine has limited efficacy. In over four years of trials, it has prevented 39 per cent of malaria cases among small children in SSA pilot countries. Yet, a study published in the New England Journal of Medicine found that administrating this vaccine and antimalarial drugs to young children before the onset of the rainy season effectively reduced the incidence of malaria by 70.5 per cent. This is not a perfect solution. However, experts believe this announcement will re-energize research efforts and mobilize funding. The century-long race to comprehensively tackle malaria is finally drawing to an end.