WHO director-general Tedros Adhanom Ghebreyesus called it a “historic moment” after a meeting in which two of the UN health agency’s expert advisory groups recommended this step.
“Today’s recommendation offers a glimmer of hope for the continent, which bears the heaviest burden of the disease. And we expect many more African children to be protected from malaria and grow into healthy adults, ”said Dr Matshidiso Moeti, WHO Director for Africa.
The WHO said its decision was largely based on findings from ongoing research in Ghana, Kenya and Malawi that has followed more than 800,000 children who have received the vaccine since 2019.
The vaccine, known as Mosquirix, was developed by GlaxoSmithKline in 1987. Although it was the first to be licensed, it faces challenges: the vaccine is only about 30% effective. requires up to four doses and its protection wears off after several months. .
Still, scientists say the vaccine could have a major impact against malaria in Africa, which is home to most of the world’s more than 200 million cases and 400,000 deaths annually.
“This is a huge step forward,” said Julian Rayner, director of the Cambridge Institute for Medical Research, which was not part of the WHO decision. “It’s an imperfect vaccine, but it will still prevent hundreds of thousands of children from dying.”
Rayner said the impact of the vaccine on the spread of mosquito-borne disease was still unclear, but cited those developed for the coronavirus as an encouraging example.
“The past two years have given us a very nuanced understanding of the importance of vaccines in saving lives and reducing hospitalizations, even if they do not directly reduce transmission,” he said.
Dr Alejandro Cravioto, head of the WHO vaccine group who made the recommendation, said designing a vaccine against malaria was particularly difficult because it is a parasitic disease spread by mosquitoes.
“We are faced with extraordinarily complex organizations,” he said. “We are not yet within reach of a highly effective vaccine, but what we have now is a vaccine that can be deployed and is safe.”
The WHO said side effects were rare, but sometimes included a fever that could lead to temporary seizures.
Sian Clarke, co-director of the Malaria Center at the London School of Hygiene and Tropical Medicine, said the vaccine would be a useful addition to other disease-fighting tools that may have exhausted their usefulness after decades of use, such as mosquito nets and insecticides. .
“In some countries where it is very hot, children just sleep outside, so they cannot be protected by a mosquito net,” Clarke said. “So obviously if they’ve been vaccinated they will still be protected.”
In recent years, little significant progress has been made against malaria, Clarke said.
“If we are to reduce the burden of disease now, we need something else,” she explained.
Azra Ghani, president of infectious diseases at Imperial College London, said she and her colleagues estimate that administering the malaria vaccine to children in Africa could lead to an overall reduction of 30%, with up to 8 million fewer cases and up to 40,000 fewer deaths per year.
“For people who don’t live in countries where malaria is rife, a reduction of 30% may not seem like much. But for people living in those areas, malaria is one of their main concerns,” Ghani said. “A 30% reduction will save a lot of lives and prevent mothers (of) from bringing their children to health centers and overwhelming the health system.”
The WHO guidelines would hopefully be a “first step” in making better malaria vaccines, she said. Efforts to produce a second-generation malaria vaccine could be boosted by messenger RNA technology used to make two of the most successful COVID-19 vaccines, those from Pfizer-BioNTech and Moderna, she added. .
“We have seen much higher antibody levels in mRNA vaccines, and they can also be adapted very quickly,” Ghani said, noting that BioNTech recently said it would start researching a possible malaria vaccine. . “It’s impossible to say how this can affect a malaria vaccine, but we definitely need new options to combat it.”
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