Killing the chills: On the malaria vaccine

The triumphs of science are best appreciated when they make human lives easier or safer, or simply, offer hope. The first ever World Health Organization (WHO)-approved anti-malaria vaccine must count among those triumphs. The approval marks a milestone in a timeline that records a long and laborious process to grapple with malaria, and somehow make it less of a killer. The vaccine that WHO has approved — RTS,S — has been used in pilot programme participants (children and infants) in Africa from 2015 after it got a nod for this specific use from the European Medicines Agency. This triumph comes at a time of great scientific endeavour, yes, but also notably at a time when it was feared that the progress against malaria was flagging. With this vaccine, which will significantly reduce the severity of cases and prevent deaths, hope has sprung anew that humankind might retard in its tracks a pathogen that has stalked sub-Saharan Africa and several other parts of the world for years now. WHO Director-General Dr. Tedros Adhanom rightly termed it as a historic moment, achieving a breakthrough not only for malaria control but also child health and science itself. The malaria vaccine, RTS,S, which has been in the making for nearly 30 years, acts against P. falciparum, believed to be the most deadly malaria parasite globally. As per WHO, in 2019, nearly half the world’s population was at risk of malaria, while most cases and deaths occur in sub-Saharan Africa. There were an estimated 229 million cases in 2019, and malaria deaths stood at 4,09,000, with the WHO African region carrying a disproportionate burden — 94% of cases and deaths. Children under five are the most vulnerable group affected by malaria; in 2019, they accounted for about two thirds of all malaria deaths.

WHO said it was making a recommendation for use based on the key findings of pilot projects implemented in child health clinics in Ghana, Kenya and Malawi over two years. Data and insights gathered from these studies showed that the vaccine was not only feasible to introduce but that it also improves health and saves lives. Remarkably, it facilitated equitable access to malaria prevention, even during the COVID-19 pandemic, helping reach even hitherto unreached populations. While further steps are taken to manufacture, fund and roll out the vaccine to nations affected by malaria, maintaining equity of access is key. Dr. Tedros emphasised in his press conference that as the work towards providing vaccination continues, nations may, by no means, relinquish their routine malaria prevention activities, including providing insecticide-treated bed nets. While the world now has a way to kill the rigors — the chills characteristic of the infection — the next step should be speedy and meticulous implementation of the scientific miracle from the lab to the field.

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