The World Health Organisation has recommended a new vaccine, R21/Matrix-M, for the prevention of malaria in children.
The recommendation follows advice from the WHO Strategic Advisory Group of Experts on Immunisation and the Malaria Policy Advisory Group and was endorsed by the WHO Director-General, Dr Tedros Ghebreyesus, following its regular biannual meeting held on September 25 -29.
The global health body disclosed this on Monday, in a press statement.
In April, Nigeria became the second country to approve the R21 malaria vaccine, after Ghana.
The R21/Matrix-M malaria vaccine, developed by the University of Oxford and manufactured and scaled up by the Serum Institute of India, is only the second vaccine the world has seen for a disease that has caused untold suffering for millennia.
WHO also issued recommendations on the advice of SAGE for new vaccines for dengue and meningitis, along with immunisation schedules and product recommendations for COVID-19.
WHO also issued key immunisation programmatic recommendations on polio, Immunisation Agenda 2030, and recovering the immunisation programme.
The R21 vaccine is the second malaria vaccine recommended by WHO, following the RTS,S/AS01 vaccine, which received a WHO recommendation in 2021.
“Both vaccines are shown to be safe and effective in preventing malaria in children and, when implemented broadly, are expected to have high public health impact,” the statement read partly.
Malaria, a mosquito-borne disease, places a particularly high burden on children in the African Region, where nearly half a million children die from the disease each year.
WHO said the demand for malaria vaccines is unprecedented; however, available supply of RTS,S/AS01 vaccine is limited.
In response to the high demand for the first-ever malaria vaccine, 12 countries in Africa were in July allocated a total of 18 million doses of RTS,S/AS01 for the 2023–2025 period.
The allocations were made to Ghana, Kenya, Malawi, Benin, Burkina Faso, Burundi, Cameroon, the Democratic Republic of the Congo, Liberia, Niger, Sierra Leone and Uganda.
However, the addition of R21 to the list of WHO-recommended malaria vaccines is expected to result in sufficient vaccine supply to benefit all children living in areas where malaria is a public health risk.
“As a malaria researcher, I used to dream of the day we would have a safe and effective vaccine against malaria. Now we have two,” said Dr Ghebreyesus. “Demand for the RTS,S vaccine far exceeds supply, so this second vaccine is a vital additional tool to protect more children faster, and to bring us closer to our vision of a malaria-free future.”
The WHO Regional Director for Africa, Dr Matshidiso Moeti, emphasised the importance of this recommendation for the continent, saying: “This second vaccine holds real potential to close the huge demand-and-supply gap. Delivered to scale and rolled out widely, the two vaccines can help bolster malaria prevention and control efforts and save hundreds of thousands of young lives in Africa from this deadly disease.”
At least 28 countries in Africa plan to introduce a WHO-recommended malaria vaccine as part of their national immunisation programmes.
Gavi, the Vaccine Alliance has approved providing technical and financial support to roll out malaria vaccines to 18 countries.
WHO also noted that the RTS,S vaccine will be rolled out in some African countries in early 2024, and the R21 malaria vaccine is expected to become available to countries in mid-2024.
According to Moeti, Nigeria has seen major progress but accounts for around 27 per cent of the global burden of malaria cases.
Moeti noted that Nigeria’s malaria incidence has fallen by 26 per cent since 2000, from 413 per 1000 to 302 per 1000 in 2021, and malaria deaths also fell by 55 per cent, from 2.1 per 1000 population to 0.9 per 1000 population.
“Drivers of this continuing disease burden include the size of Nigeria’s population, making scaling up intervention challenging; suboptimal surveillance systems, which pick up less than 40 per cent of the country’s malaria data; inadequate funding to ensure universal interventions across all states; and health-seeking behaviour, where people use the private sector, with limited regulation, preferentially,” she stated.
