The World Health Organization has recommended broad use of RTS,S, a malaria vaccine for children. Will this timely vaccine be successful in reducing malaria mortality in children? Possibly, but there are four critical factors to consider.
Globally, malaria is endemic in more than 100 countries, and responsible for over 200 million cases and 400,000 deaths annually. The disease disproportionately impacts children, with 67% of deaths caused by malaria occurring among children under the age of five. Simply put, a child dies from malaria every two minutes.
Even though proven treatment and prevention interventions, such as case management, insecticide treated nets, indoor residual spraying, intermittent preventive treatment in pregnancy, and seasonal malaria chemoprevention have significantly reduced the global burden of the disease – malaria incidence dropped dramatically between 2000 and 2015 – progress has slowed down in recent years due to funding gaps and growing resistance to antimalarials and insecticides. Current tools to combat malaria are not sufficient to achieve malaria control and elimination, and the global health community has worked hard to find new solutions.
On October 6, 2021, the World Health Organization (WHO) issued a recommendation for broad use of the RTS,S/AS01 (RTS,S) malaria vaccine, also known as Mosquirix, generating new hope in improving our ability to reduce the serious health impacts of malaria and eventually eliminate the disease. The vaccine has been under development for over three decades. The latest recommendation is centered on data collected during the Malaria Vaccine Implementation Programme pilots which took place in Kenya, Ghana, and Malawi, following successful large-scale clinical trials from 2009 to 2014. Among children ages 5 to 17 months who received four doses of RTS,S over an 18-month period, the vaccine prevented approximately 4 in 10 (39%) cases of malaria and about 3 in 10 (29%) cases of severe malaria. However, its use in combination with seasonal malaria chemoprevention has shown to reduce malaria deaths in children by 73%. The large-scale role out of RTS,S used alongside existing interventions has the potential to significantly contribute to Sustainable Development Goal 3 and the global malaria 2030 targets.
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