Africans welcome new malaria vaccine. But is it a 'game changer'?

Health officials prepare to vaccine residents of the Malawi village of Tomali. Photo / AP

The arsenal of weapons to use against malaria, which kills hundreds of thousands of people annually, just grew bigger.

When babies are born in western Kenya, where malaria is rife, many mothers are sent home from the hospital with one all-important baby gift: a bed net treated with insecticide.

"Malaria is our No. 1 health problem," said Mathews Ajwala, a community health worker who gives out the nets to ward off malarial mosquitoes that can cause severe illness and death. More than 400,000 people died of malaria worldwide in 2019, and two-thirds of those were children in Africa under age 5.

So when the World Health Organization on Wednesday announced that it had approved the world's first malaria vaccine, African parents, government officials and health workers like Ajwala celebrated the moment as a milestone in the fight against a scourge that has plagued humans for millennia.

"This vaccine will be a big game-changer," Ajwala said in a telephone interview.

The vaccine, the first developed for any parasitic disease, was widely discussed on social media and on radio and television stations Thursday. Many across the continent took pride in the fact that African scientists, research institutions and citizens helped provide and interpret the data that eventually led to approval of the vaccine. The WHO endorsement was based on the results of more than 2.3 million doses administered since 2019 to about 800,000 children in Kenya, Malawi and Ghana.

But Africans were also coming to grips with the fact that the vaccine alone will not solve the malaria problem.

In clinical trials, the vaccine, made by British pharmaceutical company GlaxoSmithKline, was effective at reducing severe malaria by only 30 per cent in the first year after it was administered, according to WHO — although some experts put the figure at closer to 50 per cent.

To be effective, four doses of the vaccine must be administered starting at the age of 5 months — which could pose logistical problems since delivering vaccines on the continent is already a challenge.

"The vaccine saves lives, but it will not be a silver bullet," said Githinji Gitahi, CEO of Amref Health Africa, a nongovernmental organization.

The vaccine, called Mosquirix, targets the deadliest malaria parasite and the most common in Africa — Plasmodium falciparum. While the vaccine is a "huge addition to the fight" against malaria, said Gitahi, health officials will still have to deploy "a Swiss cheese strategy" that includes insecticide-treated bed nets and indoor spraying.

Faith Walucho is the mother of an 11-month-old who was recently diagnosed with malaria. The 29-year-old trader of used clothing in the city of Kisumu in western Kenya said she received the news about the vaccines "with a lot of happiness." In Kenya, an estimated 10,700 deaths from malaria are recorded annually, and Kisumu, on the shores of Lake Victoria, is one of the high-malaria regions where the vaccine was tested.

As soon as she is able to get a dose for her daughter, Walucho said, "I will run" to get it.

In Malawi's capital, Lilongwe, Jenala Mwafulirwa, a 52-year-old mother of five, welcomed news of the vaccine, saying that too many children in her family had been lost to the disease, particularly in rural areas where access to health care is limited.

"This vaccine has come at the right time," she said.

But in some places, people voiced skepticism about the vaccine, in part because of mistrust of WHO.

"I wonder why they want to help Africa," said Mamadou Tounkara, a 40-year-old-teacher in Senegal's capital, Dakar. He asked why WHO did not instead fund better hygiene and sanitation systems. "If WHO wants to help eradicate this disease, they can do it without the vaccine."

Yet public health officials say the vaccine, which has been in development for more than 30 years, has already proved to be an important weapon in the war against the disease.

Lilyana Dayo, a malaria programme officer in Kisumu County, said the pilot testing reduced the effects of malaria by 18 per cent.

At the Kisumu County hospital, the vaccine has helped free up beds that could be used for other ailments, said Salome Situma, a paediatric nurse. Hospitals in the county had been overwhelmed a few months ago as the third wave of the coronavirus pandemic, fueled by the delta variant, swept Kenya and the continent

"I feel privileged to be part of the system that is achieving and heading in the right direction," Situma said.

Gitahi said the main challenge facing the malaria vaccine will be how to efficiently distribute it, not just to regions with moderate to high transmission but also to conflict zones where malaria is endemic. Health officials will also have to figure out, he says, how best to balance and match malaria vaccination with other child immunisation campaigns like polio and measles.

"That's really the big policy question," he said.

It is unclear how soon the vaccine will be widely available in Africa, Dr. John Nkengasong, director of the Africa Centers for Disease Control and Prevention, said at a news conference Thursday. He said the Africa CDC will be talking with WHO.

But many hope that when the vaccine is available, it will turn the tide on the disease once and for all.

When he was 5 years old, George Owino said he got so sick with malaria that his parents worried whether he would ever recover. Two of his three children — now ages 24, 21 and 18 — also got severely ill with the virus over the years.

"When people are told the vaccines are being rolled out, they should come out," Owino said. "It's a huge relief."

This article originally appeared in The New York Times.

Written by: Abdi Latif Dahir
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