Ongoing global efforts to tackle malaria have taken a positive turn following the authorisation of an experimental malaria vaccine for trial. This move was announced by the The World Health Organisation’s Strategic Advisory Group of Experts on Immunisation (SAGE) and the Malaria Policy Advisory Committee (MPAC). The test of the ‘Mosquirix’ vaccine is to be conducted in three to five (non-clinical setting) in order to understand how best to use the vaccine that aims to protect young children against malaria. Following earlier WHO trials, it was found that for a child to be fully protected four doses of the vaccine are required on top of additional contact with the health care system. The first three doses are given one month apart followed by an 18-month pause before the fourth dose. Without the fourth dose, children have no overall reduction in severe malaria. “The question about how the malaria vaccine may best be delivered still needs to be answered. After detailed assessment of all the evidence we recommended that this question is best addressed by having three to five large pilot implementation projects,” said Prof. Jon S. Abramson, chair of SAGE. Progress in Rwanda According to WHO, malaria is an entirely preventable and treatable mosquito-borne illness but in 2013, 97 countries had ongoing malaria transmission. Worldwide, an estimated 3.4 billion people are at risk of malaria, of which 1.2 billion are at high risk. In high-risk areas, more than one malaria case occurs per 1,000 people. Worse still, in 2012, malaria killed an estimated 482,000 children under five. That is 1,300 children every day, with 90 per cent of deaths occurring in sub-Saharan Africa. In Rwanda, the number of children under five years getting appropriate treatment within 24 hours grew from 845 in 2009 to 96 per cent in 2013. However, deaths from malaria was 439 in 2012 although these decreased to 352 in 2014 from 412 in 2013, according to information from the Ministry of Health. Dr Corine Kalema, the head of malaria and other parasitic disease division at Rwanda Biomedical Centre, said the vaccine was welcome but emphasis should be on existing malaria prevention strategies in the country. “The vaccine is an additional tool which needs to be used with other malaria control interventions. This vaccine does not replace existing proven and cost-effective methods such as using treated mosquito nets, efficacious artemisinin combination therapies and indoor residual spraying, which have shown greater impact in Rwanda,” Kalema told The New Times. He also called for the decision to involve further studies in countries with moderate transmission. “We are sure that Rwanda may be the perfect setting to be included in the pilot project if countries with moderate malaria transmission will be included in the study,” Dr Kalema added.
