Nigeria misses out as anti-malaria vaccine shipment heads to African nations

There is no mention of Nigeria (which has the highest burden of malaria in the world) as shipment of the world’s first World Health Organisation (WHO)-recommended malaria vaccine (RTS,S) began with 331,200 doses landing Tuesday night in Yaoundé, Cameroon.

The delivery, according to a joint press statement by Vaccine Alliance, Gavi, WHO and United Nations Children Fund (UNICEF), yesterday, is the first to a country not previously involved in the malaria vaccine pilot programme, and signals that scale-up of vaccination against malaria across the highest-risk areas on the African continent will begin shortly.

Nearly every minute, a child under five dies of malaria. In 2021, there were 247 million malaria cases globally, which led to 619,000 deaths. Of these deaths, 77 per cent were children under five years, mostly in Africa. Malaria burden is the highest on the African continent, accounting for approximately 95 per cent of global malaria cases and 96 per cent of related deaths in 2021.

According to the statement, a further 1.7 million doses of the RTS,S vaccine are expected to arrive in Burkina Faso, Liberia, Niger and Sierra Leone in the coming weeks, with additional African countries set to receive doses in the months ahead.

This reflects the fact that several countries are now in the final stage of preparations for malaria vaccine introduction into routine immunisation programmes, which should see first doses administered in Q1 2024.

Comprehensive preparations are needed to introduce any new vaccine into essential immunisation programmes – such as training of healthcare workers, investing in infrastructure, technical capacity, vaccine storage, community engagement and demand, and sequencing and integrating rollout alongside the delivery of other vaccines and health interventions. Delivering the malaria vaccine has the added challenge of a four-dose schedule, which requires careful planning to effectively deliver.

Since 2019, Ghana, Kenya, and Malawi have been administering the vaccine in a schedule of four doses from around five months of age in selected districts as part of the pilot programme, known as the Malaria Vaccine Implementation Programme (MVIP). More than two million children have been reached with the malaria vaccine in the three African countries through MVIP, resulting in a remarkable 13 per cent drop in all-cause mortality in children age-eligible to receive the vaccine, and substantial reductions in severe malaria illness and hospitalisations.