Impact of second vaccine to combat malaria in Africa limited by funding

University of Oxford's R21/Matrix-M vaccine is expected to be launched in mid-2024

Health officials administer the world's first vaccine against malaria in Malawi in December 2019. AP

Parents wait for their young children to receive the Mosquirix vaccine. AP

A baby from the village of Tomali is injected with the vaccine. AP

A nurse holds malaria vaccine vials at the Lumumba Sub-County Hospital in Kisumu, Kenya. Reuters

A nurse prepares to tend to a child with malaria at Marcory General Hospital in Abidjan, Ivory Coast, on October 7, 2021. Reuters

A second vaccine approved to tackle malaria in children in Africa could be limited in its effect by a lack of funding to support the breakthrough, a World Health Organisation expert said.

A second malaria vaccine has been approved by the WHO to step up the war against the life-threatening disease.

The R21/Matrix-M vaccine, developed by the University of Oxford in the UK, is expected to be available within a year, with each dose likely to cost between $2 and $4.

More than 20 million doses have already been produced in anticipation of a mass roll-out in mid-2024. Produced by the Serum Institute of India, the vaccine uses Novavax's Matrix M adjuvant.

While tens of thousands of children living in regions plagued by malaria will benefit, the vaccine must be accompanied by other sustainable measures, according to Dr Ghasem Zamani, regional adviser for malaria and vector control unit at the WHO Eastern Mediterranean office.

“Tens of thousands of young lives could be saved every year with the broad roll-out of these malaria vaccines,” Dr Zamani said.

“However, malaria vaccine will not be the whole answer [to the] alarming situation of malaria in many countries."

Dr Zamani said there needs to be a complete package of interventions to be implemented in the right time and place and in a sustainable way.

The lack of investment “is the major threat that may decrease the impact of this great development", he said.

Malaria killed an estimated 619,000 people globally in 2021, compared with 625,000 in 2020, according to the WHO’s 2022 Malaria Report.

Worldwide, there were 247 million malaria cases in 2021, compared with 245 million in 2020 and 232 million in 2019, with Nigeria accounting for almost a third of all deaths.

Challenges to deliver the vaccine include the availability of enough supply of both vaccines for introduction to all targeted areas, and the allocation of enough financial resources for funding or procurement.

At least 28 African countries, including Sudan with the region’s highest burden, have a plan to introduce malaria vaccines into their childhood immunisation programmes as part of their national malaria control strategies.

There is no technical evidence to support claims that one malaria vaccine has improved performance over another.

Pilot scheme

British drugmaker GSK's RTS, S malaria vaccine – Mosquirix – has been administered to more than 1.7 million children in pilot schemes in Ghana, Malawi and Kenya.

A further nine nations where malaria is endemic are due to join the pilot programme from early 2024. The vaccine is administered in four doses and can be given to children from five months old.

The vaccine took 35 years to develop and attacks P falciparum, the deadliest of five malaria parasites that affect humans. It is the most prevalent in Africa.

According to the WHO, Mosquirix provides a 30 per cent reduction in the most severe cases of malaria.

It is hoped that both vaccines will drastically reduce the number of malaria-related deaths, many of which are children.

With no clinical data to support which vaccine is more efficient, countries will be left to decide which one they adopt based on supply and affordability.

The UAE is a major backer in the global battle to eradicate malaria via the Roll Back Malaria initiative, committing $5 million (Dh18.3m) to an international campaign in January to address the effects of climate change on efforts to eradicate the disease.

Since 2017, a 10-year Reaching the Last Mile project, backed by a $100 million UAE fund has been supporting efforts to combat the world’s deadliest diseases.

“We are very far form malaria eradication,” Dr Zamani said.

“The current malaria vaccine and a hope for better ones that also target other species should be part of a full package of interventions including socioeconomic development for reaching all unreached populations.

“That finally can lead to us to elimination country by country and finally eradication at global level of all malaria species.”