Malaria vaccine linked to 13% decline in child mortality

AFRICA —The pilot implementation of the first malaria vaccine has yielded positive outcomes, offering hope and optimism for future interventions in malaria control.

Dr. Kate O’Brien, Director of the Department of Immunization, Vaccines and Biologicals at the World Health Organization (WHO), emphasized the remarkable progress achieved through the addition of the malaria vaccine to existing control measures.

Dr. O’Brien said, “Recent data shows a 13 percent reduction in all-cause mortality (excluding trauma) among children eligible for vaccination. Notably, this impact was achieved at approximately 64-74 percent coverage, previewing the likelihood of even greater impact as the coverage scales up.”

The move to incorporate a malaria vaccine into the portfolio of malaria interventions is seen as an optimization of imperfect strategies, aimed at alleviating the health burden on children and their families.

Dr. O’Brien underscored the potential for not only reducing suffering but also translating into substantial cost savings for healthcare systems.

The successful pilot implementation and the subsequent impact were observed in Kenya, Ghana, and Malawi, regions where malaria is a prevalent mosquito-borne disease.

In Kenya alone, the Center for Disease Control and Prevention (CDC) reports an estimated 3.5 million new clinical cases and 10,700 deaths each year, with Western Kenya being particularly vulnerable to malaria.

The vaccine, known as RTS, S/ASO1, received WHO recommendations in 2021 and has proven to be safe and effective in preventing malaria in children.

With broad implementation, they are anticipated to have a high public health impact, potentially saving the lives of nearly half a million children who succumb to the disease each year in the African region.

In a strategic move, nine additional countries in sub-Saharan Africa, including Uganda, Burundi, Cameroon, the Democratic Republic of Congo, Liberia, Niger, Benin, Burkina Faso, and Sierra Leone, are set to introduce the vaccine into their routine immunization programs starting in early 2024.

Dr. O’Brien explained, “With a WHO policy recommendation for a second malaria vaccine, R21/Matrix-M, now in place, additional countries are also planning for introduction, given the expectation for sufficient supply, once the R21/Matrix-M vaccine achieves WHO prequalification.”

Shifting focus to cervical cancer prevention, Dr. O’Brien highlighted the growing momentum of human papillomavirus (HPV) vaccination programs globally.

The global coverage for the first dose of HPV in girls increased from 16 percent in 2021 to 21 percent in 2022.

Notably, countries such as Nigeria, Bangladesh, and Cambodia have rapidly embraced HPV vaccination, joining the ranks of nations incorporating the vaccine into their national schedules.

 The upcoming introduction of HPV vaccination in India and Pakistan’s intent to join countries protecting women from cervical cancer adds to the positive momentum.

The Democratic Republic of Congo’s National Immunization Technical Advisory Group (NITAG) further strengthened the vaccination program, recommending the addition of the HPV vaccine to the national vaccination schedule.

These efforts collectively aim to significantly reduce the global burden of cervical cancer. Despite these successes, Dr. O’Brien raised concerns about the resurgence of measles globally, with increased reports of cases and deaths.

While the proportion of children receiving a first dose of the measles vaccine increased from 81 percent in 2021 to 83 percent in 2022, it remains below the 2019 level of 86 percent.

Dr. O’Brien emphasized the need for more support to countries under the banner of “The Big Catch-Up” to re-establish routine vaccination programs, improve coverage, and reach the most vulnerable populations, preventing large-scale global outbreaks of vaccine-preventable diseases.

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