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Tuesday, June 6, 2023

Now that WHO has approved malaria vaccine: Which way Nigeria?

The World Health Organisation (WHO) on  Wednesday, Oct. 6, 2021, recommended the use of the first-ever produced malaria vaccine, the RTS, S/AS01. The vaccine is an immunological approach against the plasmodium parasite.

Malaria Vaccine
Malaria vaccine

The vaccine, which showed great results in the phase III trials carried out in 2014 in about 11 African countries, has the potential of reducing global malaria deaths to a great extent.

But in July 2015, the RTS,S/AS01 (RTS,S) malaria vaccine passed its phase III clinical trial and was adopted by the European Medicine Agency.

Before this time, the vaccine was administered on children, aged 5-17 months and 3 years. The WHO approval indicates that children under the ages of five can now have the vaccine.

Malaria, a life-threatening disease, according to UNICEF, caused the death of about 260,000 children in Africa in 2020 alone.

Data from WHO also showed devastating effect of malaria.

According to the WHO, every two minutes a child dies from malaria and this fact is not exaggerated in any way as researches have proven that children under the age of five and pregnant women are most at risk of the deadly disease.

Malaria is one of the oldest diseases that have plagued the human population for several decades.

History dates it as far back as 2700 BC, while permanent solution remained vaccination, now possible after many years of researches.

Unarguably, many lives would now be saved as a result of the development and approval of the RTS, S malaria vaccine. The question at this point remains, how will this vaccine be distributed?

Will priority be accorded to high burden countries? Will children in these countries have access to this vaccine at all?

The vaccine has a four-dosage plan as its complete dose. Will children living in malaria-at-risk populations have access to the complete dose of the vaccine?

With inequalities already seen in the COVID-19 vaccination globally, what should be done to ensure that the malaria vaccine gets to the right people, at the right time, at the right place and the right dosage?

According to Dr Odinaka Obeta, Zero Malaria Youth Champion and West African Lead, ALMA Youth Advisory Council, another major area of concern is the affordability of the vaccine.

With the high cost of antimalarial in the Nigerian pharmaceutical market, what will be the fate of families living in rural areas?

Obeta noted that GSK, the manufacturers of the RTS, S malaria vaccine, said that the vaccine development had cost millions of US dollars.

However, there were plans to make the vaccine available for African children, at a not-for-profit price covering the cost of manufacturing and just about five per cent return to be reinvested in research and development of the second-generation malaria vaccines or vaccines of other neglected tropical diseases.

WHO also said that the vaccines will be distributed through the various already existing immunisation programmes established in primary healthcare systems of various countries.

“In a bid to ensure that we have wide acceptability and effective administration of the malaria vaccine, the government through the Federal Ministry of Health, must begin to educate its citizens on the malaria vaccine and also initiate risk communication programmes to help respond to any concerns citizens might have about the vaccine,” he added.

Obeta said it was also very pertinent that government begin to strengthen the primary health care structures across the nation in preparation for the vaccine, even as the continent awaits a scale-up production.

According to him, considering that Nigeria is a high burden country, the government must use this opportunity to make a good case for Nigeria to be prioritised in the distribution of the vaccine and possibly make financial commitments to support increased production before it becomes too late to participate.

Dr Ernest Nwokolo, Project Director, Society for Family Health Global Fund Malaria, said Nigeria, being one of the worst-hit by malaria, has every reason to be proactive and ensure early deployment of the vaccine.

“Early engagement, planning and deployment is expected to be critical in harvesting the good outcomes of the new vaccine,” Nwokolo noted.

He explained that it was also expected that government would facilitate the deployment of this vaccine as an additional preventive resource rather than a one-shot, single bullet replacement strategy.

“Accordingly, weaving the roll out within the confines of already existing successful interventions as well as ensuring that the other preventive and curative actions are sustained seem to be the best way to tap the positive outcomes of this new vaccine development.

“Early actions, such as policy adjustments, vaccine advocacy, integrated and sustained deployment through already successful intervention models, appropriate quantification as well as fund mobilisation are key steps that Nigerian implementers must be pushing now.

“Articulated stratification of effective interventions targeting different épidémiologies and groups might also be considered in the face of resource constraints.

“Opportunities and excitement created by the arrival of this new vaccine must be explored to revive and expand all levels and layers of partnership,” he stated.

Nwokolo added that with sustained efforts, Nigeria and other affected sub-Saharan African countries might well be taking definite last steps towards malaria elimination.

“This might just be it! It’s an exciting period! Let’s live it,” he said.

According to a professor of virology and former Vice-Chancellor, Redeemer’s University, Ede, Prof. Oyewale Tomori, the anticipated rollout of the vaccine would boost the health of millions of at-risk children on the continent.

Tomori stressed that the vaccine cannot be replaced with other measures on the prevention of malaria.

He noted that the WHO recommendation does not immediately usher in widespread use of RTS,S, rather, it marked the beginning of the vaccines.

“Yes, another bullet in the armoury against malaria, but certainly not yet the magic bullet. We must continue with the age- old and new drug therapies and most importantly the prevention methods -antiseptic nets, vector control, environmental sanitation,” he advised.

By Racheal Abujah, News Agency of Nigeria (NAN)

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