It is a year that heralds a revolution in the fight against malaria. After a pilot phase launched in 2019 in Kenya, Malawi and Ghana, which enabled the deployment of the first RTS,S (Mosquirix) vaccine from the British laboratory GSK against the parasitic disease, the precious serum has been being transported since the end of the year 2023 in thirteen African countries out of the 28 countries which plan implementation during 2024 during specific vaccination campaigns.
As of November, Senegal, Burkina Faso, Liberia, Niger and Sierra Leone had received 1.7 million doses. During the month of January, Benin, Burundi, Uganda, the Democratic Republic of Congo (DRC) and Cameroon benefited from deliveries which will enable the vaccination of millions of people, mostly children, the first victims of disease. Malaria, transmitted to humans in particular by the bite of certain mosquitoes, kills 600,000 people per year, with Africa bearing 95% of the deaths occurring in the world.
Cameroon even chose to introduce, on Monday January 22, the RTS,S vaccine directly into its national routine vaccination strategy. A first in Africa, which marks a “turning point” in the fight against this disease, Aurélia Nguyen, director of programs at GAVI, the Vaccine Alliance, which is leading this large-scale deployment, explained to AFP.
The coalition which brings together the World Health Organization (WHO), Unicef, the Bill and Melinda Gates Foundation (partners of World Africa) and the World Bank works in partnership with major international donors, governments, and stakeholders in civil society and the pharmaceutical industry to allow developing countries access, partly free of charge, to the vaccines necessary for basic health. GAVI is investing an initial amount of nearly $160 million (€147 million) for a broader deployment of the serum in countries where the disease is endemic over the period 2022-2025.
In the first pilot phase in Kenya, Malawi and Ghana, 6 million doses of the RTS,S vaccine were administered, and more than 2 million children were vaccinated, resulting in a reduction in mortality of 13% and a substantial reduction in severe cases of malaria, according to WHO data. With the prequalification by the WHO of a second anti-malaria vaccine, R21/Matrix-M from the American laboratory Novavax – which has demonstrated even greater effectiveness – and possible deployment from 2025, the fight against malaria must enter a new dimension.
Aurélia Nguyen It’s a somewhat historic day. So far, small-scale pilot introductions have been carried out in Kenya, Ghana and Malawi to understand how to use the vaccine. In Cameroon, we are moving directly to the introduction of RTS,S into the national routine vaccination strategy.
This is truly a turning point. It took thirty years to develop this first vaccine against malaria. It is a very difficult disease, because it is transmitted by a parasite which has a very complicated life cycle. This new tool, which has proven effectiveness and safety in the field, will be very useful to us: it is an important complementary tool that adds to existing prevention [spraying, impregnated mosquito nets, etc.].
There had been a lot of progress in the fight against malaria, but we had reached a point where this progress was slowing down. In some countries, the number of cases, hospitalizations and deaths are starting to rise. The causes are varied: global warming, population movements, etc.
We first decided to concentrate where the need was greatest. Cameroon is one of the countries where the incidence of the disease is quite high. We mainly focus on geographic areas where the incidence is highest and where the impact will therefore be positive. In Cameroon, 30% of medical consultations are related to malaria. Having a preventive tool like the vaccine will free up the health system and have fewer hospitalizations and deaths.
And we are working to get the vaccine into place in as many countries as possible and as quickly as possible. Twenty-eight countries want to deploy this vaccination. We hope that in the next two years, we will have a fairly broad implementation. We will first focus on the areas most at risk, and then, little by little, we will be able to expand depending on what the countries want to do. Cameroon is not the only one to receive vaccines. Nine other countries, in addition to the three pilots, have already received doses and are proceeding to the implementation phase with vaccination campaigns.
It is a disease which is transmitted by a mosquito and we see that the geographical areas where these mosquitoes proliferate are increasing. India, Asia more broadly, Latin America but also southern Europe, where malaria is regaining strength, could be interested. Discussions are underway with certain countries in these areas which, if they are eligible to receive support from GAVI, will be entitled to the same program as that which is being deployed in Africa.
