World’s first malaria vaccination programme launched in West Africa

Demand for the GlaxoSmithKline's RTS,S/ AS01  vaccine, in minimizing cases of malaria infections and deaths among children,  is expected to increase in Africa as more countries integrate its use into their respective national vaccination programmes.

The 2021 World Health Organization (WHO) approved malaria vaccine, a product of more than 30 years of research led by GlaxoSmithKline (GSK), with PATH and other partners, has been launched as part of the national vaccination programme in Cameroon, outside of the ongoing malaria vaccine pilot programme in Kenya, Ghana and Malawi. ⁽¹⁾

The public launch in January 2024 of the mosquirix vaccine in the West African country is the first in the world targeting the plasmodium falciparum circumsporozoite protein (PfCSP). The RTS malaria-hepatitis B fusion protein when co-expressed with the S antigen alone in yeast cells, forms the RTS,S virus-like particles.

The RTS,S vaccine has been adjuvanted with AS01, which consists of liposomes plus MPL plus QS21, with GSK saying its is part of the company's next wave of adjuvant technology with potential to open up "the use of antigens that may not otherwise trigger a strong enough immune response." ⁽²⁾

"The vaccine is an additional tool for malaria control and has been chosen by the country based on its pre-qualification, ensuring guaranteed quality, efficacy and safety for inclusion in the vaccination programme," said Cameroonian doctor Shalom Ndoula. ⁽³⁾

Ndoula, who is also the country's permanent secretary of the expanded programme on immunization in Cameroon said the vaccine "will specifically target all children aged six months as of 31 December 2023."

The vaccine is delivered as a lyophilized injection administered intramuscularly with the first dose given at five months of age. WHO guidelines indicate the first three doses are administered every month with the third one expected to be completed when the child is nine months.

At least 331,200 doses of the RTS,S vaccine were acquired by Cameroon in November 2023 as the government planned the rollout of the vaccination in both public and private health facilities across the country's 42 districts.

Cameroon, which reported at least 3 million malaria cases and 3800 deaths from the disease in 2021, has given the eradication of malaria priority in the government's National Health Development Plan, as the country strives to exit from the list of the 11 countries worst hit by malaria in Africa.

At least 27 other African countries are expected to launch the RTS,S vaccine immunization programme, a trend likely to trigger an increase in demand for the pharmaceutical product.

Previously, GSK had announced approval by the leadership of plans to donate up to 10 million RTS,S doses for use in the Kenya, Ghana and Malawi pilot programme and a further 15 million doses every year. ⁽⁴⁾

Prior to Cameroon's public launch of the mosquirix vaccine, several preparatory activities were carried out with the support of  WHO, Gavi, the Vaccine Alliance, the United Nations Children's Fund, Africa Centre for Disease Control & Prevention as well as Clinton Health Access Initiative.

For instance, the these organizations, in collaboration with the government of Cameroon supported the adoption, by the West Africa country, the national vaccination policy and guidelines as well as integrating the new vaccine into the delivery schedule of other vaccines and health interventions.

They also supported the development of an operational roll out plan, training of healthcare workers and investing in new and upgrading of infrastructure, building technical capacity and vaccine storage facilities as well as "ensuring formative supervision, monitoring and evaluation of the process to ensure quality vaccine delivery."

The drive to minimize the impact of malaria, especially in Africa, is expected to open more new avenues for the public and private investment in the manufacture of anti-malaria vaccines and associated adjuvants.

For instance, in early 2023, Ghana's Food and Drug Authority (FDA), granted approval to the R21 malaria vaccine, which was developed by UK's Oxford University and manufactured by Serum Institute of India PVT Ltd for use in immunization of children between five months and three years. ⁽⁵⁾

The WHO did recommend the R21/Matrix-M vaccine in the last quarter of 2023, as a second malaria vaccine, with the UN health agency saying "demand for malaria vaccines is unprecedented" and the availability of RTS,S is limited hence the additional R21 vaccine "is expected to result in sufficient vaccine supply to benefit all children living in areas where malaria is a public health risk." ⁽⁶⁾

Reference

1. https://www.afro.who.int/countries/cameroon/news/cameroon-kicks-malaria-vaccine-rollout

2. https://www.gsk.com/en-gb/behind-the-science-magazine/how-adjuvants-boost-our-immune-response/

3. https://www.afro.who.int/countries/cameroon/news/cameroon-kicks-malaria-vaccine-rollout

4. https://www.gsk.com/en-gb/media/press-releases/gsk-welcomes-who-recommendation-for-broad-roll-out-of-its-rts-sas01e-rts-s-malaria-vaccine/

5. https://twitter.com/fdaghana/status/1646756755286704128

6. https://www.who.int/news/item/02-10-2023-who-recommends-r21-matrix-m-vaccine-for-malaria-prevention-in-updated-advice-on-immunization

About the Author:

Shem Oirere

Shem Oirere graduated from the University of South Africa with a bachelor’s degree in International Relations and Diplomacy, and also holds a Diploma in Journalism from the London School of Journalism. He previously worked for the Kenya Times, Nation Media Group and The People Daily over a twenty-year span as a business writer and Sub-editor. He wishes to share a view of the scenes behind Africa's latest pharma market trends with the rest of the world.