By Sharon Atieno

With more than 260,000 African children under the age of five years dying from Malaria annually, there is hope as the World Health Organization (WHO) approves the widespread use of the RTS, S/AS01 (RTS, S) malaria vaccine among children in sub-Saharan Africa and other world regions with moderate to high P. falciparum malaria transmission.

The recommendation is based on results from an ongoing pilot programme in Ghana, Kenya and Malawi that has reached more than 800 000 children since 2019.

“This is a historic moment. The long-awaited malaria vaccine for children is a breakthrough for science, child health and malaria control,” said WHO Director-General Dr Tedros Adhanom Ghebreyesus. “Using this vaccine on top of existing tools to prevent malaria could save tens of thousands of young lives each year.”

“For centuries, malaria has stalked sub-Saharan Africa, causing immense personal suffering,” said Dr Matshidiso Moeti, WHO Regional Director for Africa. “We have long hoped for an effective malaria vaccine and now for the first time ever, we have such a vaccine recommended for widespread use. Today’s recommendation offers a glimmer of hope for the continent which shoulders the heaviest burden of the disease and we expect many more African children to be protected from malaria and grow into healthy adults.”

Based on the advice of two WHO global advisory bodies, one for immunization and the other for malaria, the Organization recommends that the malaria vaccine should be provided in a schedule of 4 doses in children from 5 months of age for the reduction of malaria disease and burden.

Among the findings of the pilot programme in three countries is that the vaccine introduction is feasible, improves health and saves lives, with good and equitable coverage of RTS, S seen through routine immunization systems even in the context of the COVID-19 pandemic.

Also, results showed that more than two-thirds of children in these countries who are not sleeping under a bed net are benefitting from the vaccine.

With more than 2.3 million doses of the vaccine being administered in the three countries, the vaccine was found to be favorably safe.

In the areas where the vaccine has been introduced, there has been no decrease in the use of insecticide-treated nets, uptake of other childhood vaccinations or health seeking behavior for febrile illness, according to the findings.

Additionally, there was significant reduction (30%) in deadly severe malaria, even when introduced in areas where insecticide-treated nets are widely used and there is good access to diagnosis and treatment.

Modelling estimates that the vaccine is cost effective in areas of moderate to high malaria transmission.

Going forward,  the pilot programme will continue in the 3 pilot countries to understand the added value of the 4th vaccine dose, and to measure longer-term impact on child deaths.