Malaria vaccine an historic but imperfect weapon, and other tools cannot be forgotten, scientists say

Existing anti-malaria measures like anti-mosquito bed nets still needed: Dr. Githinji Gitahi

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The world’s first malaria vaccine is still a “fairly imperfect vaccine,” even if its recommended widespread rollout is an historic moment in the fight against the disease, says one expert.

“The vaccine prevents just about 40 per cent of cases and about 30 per cent of all severe [cases],” said Dr. Fredros Okumu, director of science at the Ifakara Health Institute in Tanzania.

“It brings a lot of hope, but we have to understand that the fight against malaria is still far from over,” he told The Current’s Matt Galloway.

“We should view this as an additional intervention that can be put in the arsenal.”

Last week, the World Health Organization recommended that the malaria vaccine RTS,S — or Mosquirix  — should be widely given to children across Africa, saying it could save tens of thousands of lives each year.

The disease is caused by parasites in the bites of infected mosquitoes, and kills hundreds of thousands of people each year, the majority of them children under five years old. According to WHO, 94 per cent of malaria cases and deaths occur in Africa. It estimates the disease killed 386,000 Africans in 2019 alone.

WHO recommended that the vaccination drive happens alongside existing anti-malaria measures such as bednets and spraying.

But Dr. Githinji Gitahi in Nairobi, global CEO of Amref Health Africa, said there is a fear that the rollout could “deflect attention from other tools, like insecticide-treated mosquito nets.”

He compared it to the suite of public health measures advised during the COVID-19 pandemic, such as thorough hand washing, and physical distancing.

“We must not drop our guard … because of too much optimism on the new vaccine,” said Gitahi, a board member of the Africa Centres for Disease Control and Prevention.

Rollout challenges

Mosquirix is made by British drugmaker GlaxoSmithKline (GSK). It was approved by the European Union’s drugs regulator in 2015, after clinical trials in seven African countries.

Since 2019, 2.3 million doses have been administered to infants in Ghana, Kenya and Malawi in a large-scale pilot program co-ordinated by WHO. 

There will be challenges to a more widespread rollout to the rest of the continent, including the complexity of tracking and administering the vaccine’s required four doses, spread out over more than a year, Okumu said.

Individual countries will also have to “do their own mathematics” around how much vaccine they need, alongside emphasizing the continued use of existing measures like bed nets.

“This is a decision that countries have to make based on data from their own populations and create a package of what you would call a magic mix of tools that would give them the best outcome,” he said.

Gitahi said there must also be “cross-border collaboration, because malaria doesn’t carry a passport.”

With the vaccine as an extra measure, he thinks the goal of eradicating malaria could be achievable.

“We have seen it eradicated elsewhere. So why not in Africa?” he said.

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Written by Padraig Moran with files from CBC News. Produced by Lindsay Rempel and Kate Cornick.