It was a landmark day for the World Health Organization (WHO) on Tuesday, with its announcement that a vaccine against malaria will be incorporated into routine immunization programs for children in three African countries.
The pilot program for the launched in Malawi and is available to children 2 years and under. It will be followed by similar programs in Ghana and Kenya, the WHO said .
"The world has been for the last 100 years looking for a malaria vaccine," Pedro Alonso, MD, PhD, director of the WHO's Global Malaria Program, said at a press conference. "This is effectively a historical moment in the very, very long fight against malaria."
Alonso said that malaria is one of the biggest global health problems, with about 2 million cases and 400,000 deaths per year. While the last 10 to 15 years have seen "massive success" in the global fight against the disease, progress has stalled due to "flatlined" funding in the last 2 to 3 years, and there is a need for "new tools" -- even imperfect tools -- in this fight.
"This may be another imperfect tool, but if used perfectly, it will help us get back on track to seeing a world free of malaria," Alonso said.
Kate O'Brien, MD, director of the WHO's Department of Immunization, Vaccines, and Biologicals outlined how this vaccine represents a series of firsts -- among them, it was the first and only vaccine to show some protection against malaria in Africa (namely against the Plasmodium falciparum parasite, the most prevalent on the continent), the first malaria vaccine to be recommended by the WHO, and the first vaccine to reach children in Africa through a routine immunization program, not a clinical trial.
Despite a poor phone connection, Felicitas Zawaira, MD, director of the Department of Family and Reproductive Health at the WHO Regional Office in Africa, participated in the call with audible enthusiasm, characterizing the vaccine as a "breakthrough" and a "dream come true for many."
"This is a day to celebrate," Zawaira said.
Throughout the press conference, WHO researchers emphasized that this was not a clinical trial -- that the RTS,S vaccine had already been tested in trials in over 10,000 children, and was found to be safe and well-tolerated.
Instead, this will be a pilot program, where the vaccine will be part of routine immunization programs for children in Malawi, Ghana, and Kenya. O'Brien said that about 360,000 children will be vaccinated each year across the three countries.
Over the next 2 years, the WHO will gather data to help the organization make a broader policy recommendation about a potential larger rollout of the vaccine. As part of the pilot program, partners in each country, including the WHO, will evaluate the impact of the vaccine when it's deployed in a routine setting, including how clinicians incorporate the vaccination into their busy practices, the optimal number of doses, as well as the experience of families in the clinic.
Other programmatic decisions may also come into play. Alonso cited the need to understand where the vaccine would be adding benefit -- whether it would be to all areas where malaria is endemic, or only the ones with the greatest need. Then there would need to be enough vaccine to meet demands, and funding mechanisms to support its deployment, Alonso added.
Mary Hamel, MD, senior technical officer of the WHO's RTS,S Malaria Vaccine Implementation Program, called in from Malawi, where she had witnessed the first day of the rollout.
"I've seen children being vaccinated in the clinic today and heard about the hopes of the vaccine [from mothers and clinicians]," she said.
O'Brien added how a malaria vaccine, and vaccines in general, fit into a WHO vision of health security and help to advance health prosperity for people around the world regardless of poverty level, since immunization has the highest coverage among health services.
"Vaccines are a universal right," she said.