This week Cameroon became the first African country to receive the Mosquirix malaria vaccine for use as a fully tested preventive in a wide range of health care settings. A shipment of more than 331,000 doses arrived yesterday at the airport of the capital Yaounde. The vaccine underwent a successful four-year trial program in children in Ghana, Kenya and Malawi.
Malaria is a mosquito-borne disease that carries with it a particularly high disease burden among children in Africa. Only in the 20th century, malaria claimed between 150 and 300 millions of lives worldwide. Every year, nearly 600,000 children die from the communicable disease worldwide, more than 500,000 of which are in Africa. The vast majority of victims are under the age of five.
Until the late 1990s, malaria was considered one of the world’s neglected tropical diseases. At the time, the World Health Organization labeled the “big three” infectious diseases, HIV, tuberculosis and malaria, as the most deadly “poverty-related” diseases in the developing world.
This led to the creation of the Global Fund to Fight AIDS, Tuberculosis and Malaria, which mobilized significant resources to promote prevention and treatment of all three diseases. The work of the Global Fund along with the commitment of malaria research and development funds has paid off.
Mosquirix, RTS, S/AS01, is a recombinant protein-based vaccine. The vaccine was initially developed in 1987but it took more than 30 years to launch a pilot implementation program in endemic countries in 2019.
This first-generation malaria vaccine shows modest efficacy against the disease and holds promise as an important public health tool, especially for children in high-transmission areas where mortality is high.
The WHO granted Mosquirix pre-qualification in 2021, which meant that UN agencies such as UNICEF could procure the vaccine in partnership with Gavi, the Vaccine Alliance and eligible countries.
As of 2022 the vaccine had been administered to about one million children living in areas with moderate to high malaria transmission as part of an extensive testing program.
But now Cameroon has become the first African country to begin using Mosquirix as a fully tested preventative in numerous healthcare facilities across the nation. This first batch of vaccines will be distributed to 42 of the country’s 203 health districts. And the first jabs are expected to be given within a month and will be given mainly to children under the age of five.
The Mosquirix vaccine will be further rolled out next year in nine countries where malaria is endemic. In addition, some 18 African countries are set to receive 18 million doses over the next two years. By 2026 demand across Africa could reach 40 to 60 million doses.
Vaccines like Mosquirix save children’s lives. In areas where Mosquirix was tested, infant mortality decreased 13%. Clinical researchers and healthcare workers expect it save tens of thousands children’s lives.
In the meantime, the WHO has also recommended a second malaria vaccine. This vaccine, R21/Matrix-Mit is less expensive and will be available in the middle of next year.
The initiation of mass administration of an approved malaria vaccine represents an important global public health measure that will help reduce the burden of disease and save lives.