Advocacy &Vaccine Bill Brieger | 25 Apr 2022 10:31 am
World Immunization Week Starts with World Malaria Day
One might think initially that the convergence of World Malaria Day and World Immunization Week would simply be a coincidence. This year there is a major connection since WHO has approved the first ever RTS,S/AS01 malaria vaccine which has undergone decades to clinical testing and most recently, a successful 3-year pilot intervention in Malawi, Kenya, and Ghana.
During her keynote address at the Johns Hopkins Malaria Institute’s World Malaria Day Webinar today, The WHO Regional Director for the African Region, Dr. Matshidiso Moeti, stressed the importance of integrated disease control efforts drawing on the region’s efforts to tackle neglected tropical diseases, COVID-19 and of course, malaria. She highlighted the importance of surveillance, and in That context pointed out a serious fact. The population of sub-Saharan Africa had doubled since the start of the Roll Back Malaria initiative, meaning that to achieve the same level of coverage of key interventions, one needs to reach many more people, whether for malaria control or child immunization.
Thus, increasing targets and goals affect both immunization and malaria programs, as well as efforts to roll out the malaria vaccine. At present there is only one producer of the vaccine, GlaxoSmithKline, and while that company is working with another company in India to produce RTS,S in the global south, GSK is maintaining control of the AS01 adjuvant. Production targets have so far been geared to meeting the needs in the pilot districts of the three intervention countries, and for the foreseeable future this will address less than 10% of need in P. falciparum endemic areas, especially in Africa.
WHO and partners including UNICEF and GAVI are in the process of figuring out equitable ways to distribute what is available now and encouraging the ramp up of vaccine production. The need to vaccine technology transfer to Africa is also being considered. Additionally, eyes are focused on new malaria vaccine candidates which might come on board in about five years.
The current malaria vaccine, while reducing severe disease, does not have the highest efficacy, and experts caution that is is therefore, not a silver bullet. They do explain that the vaccine is an important addition to the malaria toolkit, and should be a central part of integrated malaria control planning. At present though, we are not only running in place to meet the needs of an ever increasing number of children at risk, and we also must cope in an ethical and efficient way with limited supplies of the vaccine for the near future. This is the double challenge to start Malaria Day and Vaccine Week.