Malaria vaccine to be introduced in Africa despite funding cuts

Bill & Melinda Gates Foundation withdraws financial support after $200 million of research investment

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 malaria vaccine that could save thousands of African lives will no longer be supported by the Bill & Melinda Gates Foundation, despite the organisation spending more than $200 million on research.

Mosquirix, sold by GlaxoSmithKline, requires four doses but is only about 30 per cent effective in countering the killer disease spread by mosquitoes.

The World Health Organisation has described the vaccine as ‘historic’, with preparations to introduce Mosquirix in Malawi, Kenya and Ghana - the three African countries where successful pilot projects were carried out.

Philip Welkhoff, the Gates Foundation’s director of malaria programmes, said direct financial support for the vaccine would be suspended because of its expense and logistical challenges, although the foundation would continue to prop-up Gavi, a vaccines alliance supported by the WHO and World Bank that aims to expand access to vaccines globally, particularly among vulnerable children.

“If we’re trying to save as many lives with our existing funding, then cost-effectiveness matters,” Mr Welkhoff told the Associated Press.

“We’re supporting the roll-out via the Gavi funding, but we decided we would not dedicate additional direct funding to extend the supply of the vaccine.”

Mosquirix is the result of several decades of research, with the foundation largely responsible for bringing it to market.

It is given to children aged 6 weeks to 17 months to help protect against malaria caused by the parasite Plasmodium falciparum.

During lengthy trials, Mosquirix proved effective at reducing the number of children with malaria, a year after taking a third injection of the vaccine.

More than 12,000 children across seven African nations took part in a study of the vaccine.

Results showed the number of children who had malaria in a 12-month period was lower by 24 per cent among those aged 6 to 12 weeks after a first dose, and by 43 per cent in children given the first dose between the age of 5 to 17 months.

Minimal side effects of a fever were reported in one in four children, although one in 1,000 children had more serious febrile seizures after taking the vaccine.

The vaccine also induced antibodies to protect against the hepatitis B virus, although it is not currently recommended for protection.

Despite ending direct financial support for Mosquirix, the foundation promised to continue funding initiatives and research aimed at ending malaria and other neglected tropical diseases.

At the 26th Commonwealth Heads of Government Meeting, held in Kigali, Rwanda in June, the WHO praised the Bill & Melinda Gates Foundation for its pledge to donate $140m over four years for the cause.

The funding will also help develop research by African institutions.

WHO estimates show that roughly 100 million doses a year of the four-dose vaccine will be needed, which would cover around 25 million children.

According to a Reuters review, GlaxoSmithKline's maximum target of 15 million doses could prevent up to about 20,000 deaths each year but that could take years.

Wider distribution beyond the pilot countries was unlikely before early 2024, and even then it would start slowly.

So far, about 1.3 million children have benefitted from the vaccine in the three African pilot countries.

Other nations most impacted by malaria can apply for funding to introduce vaccines, under the WHO partnership with Gavi, the Vaccine Alliance.

It has generated $160 million of funding to cover the costs of vaccines and their delivery from 2022-2025 for children at high risk of illness and death.

As supply is limited as vaccine production ramps up, nations must apply in stages from September and then January 2023.

“Now is the time for African countries and communities to call out their interest – to donors, health leaders and manufacturers – in early access to this vaccine,” said Dr Matshidiso Moeti, WHO Regional Director for Africa.

“Lives are at stake, every day.

“This situation underlines once again why expanded local production of vaccines is essential for meeting health needs in Africa.

“We’ve seen encouraging first steps in that direction in recent months, and we are committed to supporting further efforts to expand vaccine production in Africa.”