Malaria is a mosquito-borne disease that carries a particularly high burden of disease among children in Africa. In the 20th century alone, malaria caused between 150 and 300 million deaths worldwide. Every year, almost 600,000 children die from the communicable disease worldwide, more than 500,000 of them in Africa. The vast majority of victims are under five years old.
Until the late 1990s, malaria was considered one of the world’s neglected tropical diseases. At that time, the World Health Organization described the “big three” infectious diseases HIV, tuberculosis and malaria as the deadliest “poverty-related” diseases in developing countries.
This led to the creation of the Global Fund to Fight AIDS, Tuberculosis and Malaria, which mobilized significant resources to advance the prevention and treatment of all three diseases. The work of the Global Fund and the provision of research and development funding for malaria has borne fruit.
Mosquirix, RTS, S/AS01, is a recombinant protein-based vaccine. The vaccine was originally developed in 1987, but it took more than 30 years until a pilot program began in 2019 for implementation in endemic countries.
This first-generation malaria vaccine shows moderate effectiveness against the disease and promises to be an important public health tool, particularly for children in areas with high transmission and high mortality.
WHO granted prequalification to Mosquirix in 2021, meaning United Nations agencies such as UNICEF could procure the vaccine in partnership with Gavi, the Vaccine Alliance and eligible countries.
By 2022, the vaccine had been administered to approximately one million children living in areas with moderate to high malaria transmission as part of an extensive testing program.
But now Cameroon is the first African country to begin using Mosquirix as a fully tested preventative in numerous health facilities across the country. This first shipment of vaccines will be distributed to 42 of the country’s 203 health districts. And the first vaccinations are expected to be administered within a month and will mainly be given to children under five.
The Mosquirix vaccine will be rolled out further next year in nine countries where malaria is endemic. In addition, around 18 African countries are expected 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 the areas where Mosquirix was tested, child mortality fell by 13%. Clinical researchers and healthcare workers believe this will save tens of thousands of children’s lives.
The WHO has now also recommended a second malaria vaccination. This vaccine, R21/Matrix-M, is cheaper and will be available by the middle of next year.
The start of mass administration of an approved malaria vaccine represents an important global public health effort that will help reduce the burden of disease and save lives.