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World’s first malaria vaccine will be tested in Kenya, Ghana and Malawi (downtoearth,)

The world’s first malaria vaccine will be tested on people from three African countries—Ghana, Kenya and Malawi. On April 24, the World Health Organization announced that these three countries have been chosen to test the malaria vaccine. In 2016, Down To Earth had reported that the world’s first malaria vaccine will be rolled out in sub-Saharan Africa. This part of the continent is hardest hit.

Malaria remains a major health challenge, infecting more than 200 million people every year and killing about half a million. Children in Africa are the most vulnerable. In 2015, 88 per cent of global cases and 90 per cent of global deaths occurred in Africa.

Percentage fo malaria deaths occurring in children in Africa. Credit: Peter W. Gething, et al./ New England Journal of Medicine
Percentage fo malaria deaths occurring in children in Africa. Credit: Peter W. Gething, et al./ New England Journal of Medicine

The three countries will begin piloting the injectable vaccine in 2018.

The vaccine, which has reported partial effectiveness, can save tens of thousands of lives if used with existing measures, according to the WHO regional director for Africa, Matshidiso Moeti. However, the challenge lies in delivering four doses of the vaccine for each child in impoverished countries. For prevention, the countries rely on bed netting and insecticides.

Why these three countries?

Kenya, Ghana and Malawi were chosen for the pilot programme because they continue to have high numbers of malaria cases despite having strong prevention and vaccination programmes. The vaccines will be tested on children five to 17 months old through the existing vaccination programmes in each country.

Low treatment and bed-net coverage in Africa. Credit: Peter W. Gething, et al./ New England Journal of Medicine
Low treatment and bed-net coverage in Africa. Credit: Peter W. Gething, et al./ New England Journal of Medicine

The objective is to see whether its protective effects prove to be true under real-life conditions. At least 120,000 children in each of the three countries will receive the vaccine.

The WHO is hoping to eradicate malaria by 2040 despite increasing resistance to anti-malarial drugs—a problem that exists not just in Africa but also in India.

The vaccine has been developed by GlaxoSmithKline. The first phase is being funded ($49 million) by global vaccine alliance GAVI, UNITAID and Global Fund to Fight AIDS, Tuberculosis and Malaria.

Estimated number and rate of Plasmodium falciparum deaths in Sub-Saharan Africa in 2015. Credit: Peter W. Gething, et al./ New England Journal of Medicine
Estimated number and rate of Plasmodium falciparum deaths in Sub-Saharan Africa in 2015. Credit: Peter W. Gething, et al./ New England Journal of Medicine

Some positive developments since 2000

According to a report published in The New England Journal of Medicine in October 2016, the malaria death rate in sub-Saharan Africa has declined by 57 per cent between 2000 and 2015.
Areas with high malaria mortality (>10 per 10,000) and low coverage (<50 per cent) of insecticide-treated bed nets and anti-malarial drugs included much of Nigeria, Angola, and Cameroon and parts of the Central African Republic, Congo, Guinea, and Equatorial Guinea.
Two countries with the highest malaria burden also saw large declines in rates: Nigeria (23.6 to 10.5 per 10,000) and Democratic Republic of Congo (24.8 to 10.3 per 10,000)
As transmission declined between 2000 and 2015, the share of annual malaria deaths in children four years or younger and those between five and 14 years decreased from 78.7 per cent to 73.5 per cent and from 6.7 per cent to 4.8 per cent respectively.
However, the share of annual malaria deaths in persons 15 years or older increased from 14.6 per cent to 21.7 per cent.

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