Global malaria game-changer as WHO recommends first vaccine against world’s oldest pandemic that kills 400,000 people every year

Wednesday, October 6, 2021, was a historic day for global health. The World Health Organization recommended for the first time a broad use of the world’s first malaria vaccine.

The WHO recommended that the new malaria RTS,S/AS01 vaccine be provided to children in four doses starting when they are 5 months old. More than 260,000 children under 5 years of age die from malaria in Africa each year.

Health experts, however cautioned that the new vaccine does not replace other public health measures to reduce transmission and prevent death, including the usage of insecticide-treated bed nets.

The WHO’s recommendation was based on the advice of two advisory groups: the Strategic Advisory Group of Experts on Immunization, or SAGE; and the WHO Malaria Policy Advisory Group, or MPAG.  Their advice was formulated based on a detailed review of the evidence carried out by the SAGE-MPAG Working Group, chaired by Dr. Peter Smith.

At a press conference from Geneva, the WHO Director-General Tedros Adhanom Ghebreyesus, who started his career as a malaria researcher, the recommendation to use RTS,S/AS01 vaccine, which was 30 years in the making, was based on results from an ongoing pilot program in Ghana, Kenya and Malawi that has reached more than 800 thousand children since 2019.

Dr. Tedros acknowledged that since 2000, malaria deaths have fallen by more than half as the world succeeded in eliminating malaria from many parts of the world, however, globally, “progress has stalled at an unacceptably high level, with more than 200 million cases and 400 thousand deaths every year. Two-thirds of those deaths are children under five in Africa,” he said.

The WHO chief said, “As some of you may know, I started my career as a malaria researcher, and I longed for the day that we would have an effective vaccine against this ancient and terrible disease,” he said.

“Today is that day; an historic day.

“Today, WHO is recommending the broad use of the world’s first malaria vaccine.

“This recommendation is based on results from an ongoing pilot programme in Ghana, Kenya and Malawi that has reached more than 800 thousand children since 2019.

This long-awaited malaria vaccine is a breakthrough for science, child health and malaria control. Using this vaccine in addition to existing  tools to prevent malaria could save tens of thousands of young lives each year.

“We have made incredible progress in the fight against malaria in the past 2 decades.

“Since 2000, malaria deaths have fallen by more than half, and we have succeeded in eliminating malaria from many parts of the world.

“But globally, progress has stalled at an unacceptably high level, with more than 200 million cases and 400 thousand deaths every year. Two-thirds of those deaths are children under five in Africa.

“WHO has said consistently that we need new tools to get malaria control back on track.

“Two years ago, WHO and our partners began a pilot programme to roll out this vaccine in Ghana, Kenya and Malawi.

“Here is what we’ve learned:

This vaccine can be delivered through child health clinics by Ministries of Health, and readily reach children at high coverage levels;

“Community demand for the vaccine is strong;

It has broad reach to children – including the most vulnerable who may not use a bednet, thereby expanding access to preventive measures to children at risk.

“It’s safe;

“It significantly reduces life-threatening severe malaria;

“And we estimate it to be highly cost-effective.

“This is a powerful new tool, but like COVID-19 vaccines, it’s not the only tool. Vaccination against malaria does not replace or reduce the need for other measures, including bednets, or seeking care for fever.

“Of course, the key to any public health endeavour of this size and scope is partnership.

“I thank the children, families and communities who have participated in this historic pilot programme;

“I thank the Ministries of Health of Ghana, Kenya and Malawi for their leadership in embarking on these pilot programmes, which have continued despite COVID-19;

“I thank the researchers in Africa who generated the data and insights that informed this decision – this is a vaccine developed in Africa, by African scientists, and we’re very proud.

“I thank GlaxoSmithKline and many research partners for creating the vaccine, and PATH for bringing it from discovery through development, with support from The Bill & Melinda Gates Foundation.

“And I thank Gavi, the Global Fund and Unitaid, who funded the pilot programmes and the evaluations.

“Malaria has been with us for millennia, and the dream of a malaria vaccine has been a long-held but unattainable dream.

“Today, the RTS,S malaria vaccine – more than 30 years in the making – changes the course of public health history.

“We still have a very long road to travel. But this is a long stride down that road.

This vaccine is a gift to the world, but its value will be felt most in Africa, because that’s where the burden of malaria is greatest.”