Doubts over malaria vaccine
Experts question efficacy
Barely a month after the World Health Organisation (WHO) approved malaria vaccine rollout in Malawi, medical experts and commentators have doubted chances of the vaccine becoming a single solution for arresting malaria cases in Malawi.
This is happening at a time WHO has indicated that the vaccine, called RTS,S/AS01 (RTS,S) offers no protection against P. vivax malaria, which it says “predominates in many countries outside of Africa”.
In its ‘The malaria vaccine implementation programme’, the global health watchdog indicates that RTS,S is a vaccine that acts against Plasmodium falciparum, the deadliest malaria parasite globally and the most prevalent in Africa.
However, India-based Dr Naveen Thacker—a well-known paediatrician, Director of Deep Children Hospital & Research Centre at Gandhidham- Kutch and an Adjunct Professor of Paediatrics at Pramukhswami Medical College— indicated to The Daily Times that the malaria vaccine cannot be depended on as a stand-alone strategy against malaria.
He said, gauging by its efficacy of around 50 percent, people in targeted countries would still have to follow other preventative measures, notably sleeping in a mosquito net, fumigating swampy areas, among others.
“People will have to continue following measures they follow because, looking at the efficacy of the vaccine, people cannot solely depend on it,” said Thacker, who once served as a Steering Committee Member of Immunisation Partners of Asia Pacific between 2017 and 2019.
In January 2016, WHO recommended the malaria vaccine for pilot introduction in selected areas of Africa and in its phase three trial, which was conducted for five years from 2009 to 2014, approximately 15,000 young children and infants in seven sub- Saharan African countries, including Malawi, enrolled in the research. The other countries are Burkina Faso, Gabon, Ghana, Kenya, Mozambique and the United Republic of Tanzania.
Commenting on the issue of low efficacy of the vaccine, Ministry of Health spokesperson Adrian Chikumbe acknowledged that people will have to complement the vaccine with pre-existing methods of controlling the disease.
“Even if the efficacy was over 70 percent, we would still encourage people to be following the other ways of fighting diseases. For example, we administer cholera vaccine, which has the efficacy of over 80 percent, but we still encourage people to avoid getting water from unprotected sources and covering their food all the time.
“The vaccine is here but people will still have to be sleeping under mosquito nets avoiding keeping stagnant water where mosquitoes breed as additional ways of fighting the disease,” he said.
The malaria vaccine has been administered in 11 districts of Malawi for three years now.
However, earlier last month, WHO officials nodded to Malawi’s plans to roll out a national vaccination programme.
With over six million cases annually, malaria is one of the public health problems that cost the country huge financial resources in prevention, treatment and awareness expenses.
It is also the country’s top killer, ravaging more at the under-five children level, and immunisation is expected to have massive economic and health impacts on Malawi and other countries with high levels of malaria infection.
Meanwhile, health rights advocate George Jobe, who is also Malawi Health Equity Network Executive Director, has said there is a need for Malawians to understand the effectiveness of the vaccine for them not to become complacent on malaria prevention issues.
He, however, said it was important that the country still accepts the vaccine even although it has the efficacy of around 50 percent.
“At the same time, people have to guard against complacency in the fight against malaria because they cannot only depend on the vaccine,” Jobe said.
He added that the government should not leave everything in the hands of development partners but find resources to invest in vaccine administration.
“You know it was a few countries, including Malawi, Kenya and Uganda, that accepted the piloting of the vaccine on their citizens; so, it does not make sense that other countries should benefit more,” he said.
WHO Director General Tedros Adhanom Ghebreyesus last month described introduction of the vaccine as “a historic moment”.