On Wednesday, the World Health Organization (WHO) endorsed the use of the first ever vaccine to prevent malaria, a move that could save tens of thousands of lives each year.
According to the WHO, there were an estimated 229 million cases of malaria in 2019, killing over 400,000 people worldwide. Children are especially vulnerable to the disease, which is most present in sub-Saharan Africa; children under the age of five accounted for two thirds of the deaths that year.
Various studies have shown limited efficacy rates for the vaccine, with clinical trials showing that the vaccine prevents only about 30 percent of severe malaria cases among children. However, a study in August found that layering the vaccine with antimalarial drugs led to a 70 percent reduction in hospitalizations and deaths.
WHO researchers expect the vaccine’s rollout to have a positive impact. A study last year projected that, if vaccination rollout was prioritized by local governments, it would prevent 5.3 million cases and 24,000 deaths in children a year.
WHO General Director Tedros Adhanom Ghebreyesus hailed the recommendation as a “historic moment,” thanking participants in a pilot program in Ghana, Kenya and Malawi, as well as GlaxoSmithKlein, the company that developed the vaccine, which is known as RTS,S. “The long-awaited malaria vaccine for children is a breakthrough for science, child health and malaria control,” he said in a statement.
Tedros emphasized in a press conference on Wednesday that the vaccine rollout will not be enough on its own, and that other mitigation measures will be necessary. “Using this vaccine in addition to existing tools to prevent malaria could save tens of thousands of young lives each year,” Tedros said.
The vaccine is given out in four doses, starting in children about five or six months old and ending around two years old. Over 800,000 children have already been vaccinated through the program, and Tedros notes that the program has seen success.
Advocates hope that the vaccine’s approval by the WHO will help speed along the development of other potential vaccines. RTS,S, which has been under development for decades, has been the most successful vaccine against malaria thus far. It is not only the first antimalarial vaccine but also the first anti-parasite vaccine to be developed.
Malaria is an especially pernicious disease, and in some regions, children have malaria episodes six times a year on average. Often, cases can cause unbearable pain, and in cases where the person survives, the parasite alters the human body to attract more mosquitos, making patients more susceptible to future episodes. More infections can lead to a host of other illnesses like anemia and cognitive impairment.
Ninety-five percent of malaria cases occurred in 29 countries in 2019, and just over half of those cases were in Nigeria, the Democratic Republic of the Congo, Uganda, Mozambique or Niger. Though the incidence rate of the disease has been declining, the decline in cases and deaths have not been on par with the WHO’s long-term strategy to fight the disease.
In previous decades, the global North and other wealthier regions have been able to eliminate malaria without use of a vaccine, using infrastructure and housing improvements and removing breeding sites for mosquitos. According to the Gates Foundation, eradicating malaria entirely would cost between $90 billion and $120 billion.
The U.S. has been involved in such efforts through the President’s Malaria Initiative, started by George W. Bush in 2005, but international efforts to help with disease prevention have been criticized for being inefficient and underfunded.