Malawi becomes first country in the world to vaccinate children against malaria

Malaria kills about 435,000 people every year, the majority are children in Africa aged under five

A Health Surveilance Assistant (HAS) civic educates a mother (R) before giving her child a dose of Malaria Vaccine as Expanded Programme for Immunization Programme Manager Temwe Mzengeza (2nd R), and Hanifa Likaka (3rd R), Senior Nursing Officer and Matron for the vaccine launch venue hospital, look on on April 23, 2019 at Mitundu Community hospital in Malawi's capital district of Lilongwe on the first day of the Malaria vaccine implementation pilot programme in Malawi aiming to immunise 120,000 children aged two years and under to assess the effectiveness of the pilot vaccine and whether the delivery process is feasible. Malawi spearhead today large scale pilot tests for the world's most advanced experimental malaria vaccine in a bid to prevent the disease that kills hundreds of thousands across Africa each year. After more than three decades in development and almost $1 billion in investment, the cutting-edge trial will be rolled out in Malawi's capital Lilongwe this week and then in Kenya and Ghana next week.
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Malawi has become the first country in the world to immunise children against malaria.

The initiative is expected to save thousands of lives.

Although the vaccine only protects about one-third of children who are immunised, those who get the shots are likely to have less severe cases of malaria.

The parasitic disease kills about 435,000 people every year, the majority of them are youngsters aged under five in Africa.

Alister Craig, dean of biological sciences at the Liverpool School of Tropical Medicine, said immunising the most vulnerable children during peak malaria seasons could spare many thousands from falling ill or even dying.

"It's an imperfect vaccine but it still has the potential to save tens of thousands of lives," he said.

The vaccine, known as Mosquirix, was developed by GlaxoSmithKline and was approved by the European Medicines Agency in 2015.

A previous trial showed the vaccine was about 30 per cent effective in children who got four doses, but that protection waned over time. Reported side effects include pain, fever and convulsions.

Pedro Alonso, director of WHO's malaria program, called the vaccination rollout a "historical moment," noting that it was significantly more difficult to design a vaccine against a parasite as opposed to a bacterium or virus.

He acknowledged the vaccine was flawed but said the world could not afford to wait for a better option.

"We don't know how long it will take to develop the next-generation vaccine," he said.

"It may be many, many years away."

In the meantime, he said, the stalled progress against malaria demanded new tools now.

Resistance is growing to medicines that treat the disease, while mosquitoes are becoming more resistant to insecticides.

In addition, funding for malaria efforts has plateaued in recent years.

Alonso said similar vaccination programs would begin in the coming weeks in Kenya and Ghana, with the aim of reaching about 360,000 children across the three countries.

GSK is donating up to 10 million vaccine doses.

Other experts warned the vaccination programs should not divert limited public health funds from inexpensive and proven tools to curb malaria such as bed nets and insecticides.

"This is a bold thing to do, but it's not a silver bullet," said Thomas Churcher, a malaria expert at Imperial College London.

"As long as using the vaccine doesn't interfere with other efforts, like the urgent need for new insecticides, it is a good thing to do."

Mr Craig said one of health officials' biggest challenges could be convincing parents to bring their children for repeated doses of a vaccine that only protects about a third of children for a limited amount of time.

More commonly used vaccines, like those for polio and measles, work more than 90 per cent of the time.

"This malaria vaccine is going to save many lives, even if it is not as good as we would like," Mr Craig added.

"But I hope this will kick-start other research efforts so that the story doesn't end here."