There was a sigh of relief especially in Nigeria recently when the World Health Organisation (WHO) recommended widespread use of the RTS, S/AS01 (RTS, S) malaria vaccine for children in sub-Saharan Africa and other regions with moderate to high P. falciparum malaria transmission. The recommendation is based on results from the ongoing pilot programme in Ghana, Kenya, and Malawi that has reached more than 800 000 children since 2019.
The RTS, S malaria vaccine is the result of 30 years of research and development by GlaxoSmithKline plc (GSK) and through a partnership with PATH, with support from a network of African research centers.
“This is a historic moment. The long-awaited malaria vaccine for children is a breakthrough for science, child health, and malaria control,” said WHO Director-General, Dr. Tedros Adhanom Ghebreyesus. “Using this vaccine on top of existing tools to prevent malaria could save tens of thousands of young lives each year.”
Malaria remains a primary cause of childhood illness and death in sub-Saharan Africa. It is a life-threatening disease caused by parasites that are transmitted to people through the bites of infected female Anopheles mosquitoes. It is preventable and curable. In 2019, there were an estimated 229 million cases of malaria worldwide. The estimated number of malaria deaths stood at 409 000 in 2019.
Children aged under five years are the most vulnerable group affected by malaria; in 2019, they accounted for 67 per cent (274 000) of all malaria deaths worldwide. The WHO African Region carries a disproportionately high share of the global malaria burden. In 2019, the region was home to 94 per cent of malaria cases and deaths
Regrettably, in the opinion of this newspaper, while many countries have eradicated malaria, it remains a scourge in Africa and Nigeria especially and the reasons are not far-fetched. For instance, globally, 40 countries and territories have been granted a malaria-free certification from WHO – including, most recently, El Salvador (2021), Algeria (2019), Argentina (2019), Paraguay (2018), and Uzbekistan (2018).
Also, China is the first country in the WHO Western Pacific Region to be awarded a malaria-free certification this year in more than three decades. Other countries in the region that have achieved this status include Australia (1981), Singapore (1982), and Brunei Darussalam (1987). Malaria was eradicated in Europe by the combination of insecticide spraying, drug therapy, and environmental engineering.
Sadly, in our view, a 2020 World Malaria Report revealed that Nigeria had the highest number of global malaria cases (27 per cent of global malaria cases) in 2019 and accounted for the highest number of deaths (23 per cent of global malaria deaths).
Case numbers increased 3.5 per cent between 2016 and 2019, from 293 to 303 per 1000 of the population at risk. Deaths fell 16 per cent, however, from 0.57 to 0.47 per 1000 of the population at risk during that same period.
Microscopy data from the 2018 Nigeria Demographic and Health Survey (NDHS) show that the prevalence of malaria parasitemia in children under five years of age is 23 percent (a decrease from 27 per cent in 2015 and 42 per cent in 2010), although there are significant regional, rural-urban, and socioeconomic differences.
Prevalence ranges from 16 per cent in the South and southeast Zones to 34 per cent in the North West Zone. In rural populations, prevalence is 2.4 times that in urban populations (31 per cent vs. 13 per cent). Compared to the highest socioeconomic group, prevalence among children in the lowest socioeconomic group is seven times higher (38 per cent vs. 6 per cent).
In the considered opinion of this newspaper, the malaria vaccine is a welcome development. Therefore, we call on the federal government to make adequate provisions to purchase the vaccine when it becomes available. The scourge of malaria is more deadly in Nigeria than the COVID-19 pandemic. The government should not replicate t the debacle where the country waits for donations from wealthy nations.
Indeed, we call on the government to embark on a serious enlightenment campaign for people to take the vaccine when it becomes available. There has been a serious campaign by some religious and political leaders against taking the COVID -19 vaccine. It should be not be allowed to replicate itself in the malaria vaccine.
All efforts should be made by the federal government to produce its own Malaria vaccine. As the President of the African Development Bank Group, Dr. Akinwunmi Adesina said recently, Africa should be producing and not begging for vaccines. According to him, the African Development Bank will invest $3 billion in support of local pharmaceutical industries in Africa, including Nigeria.
Similarly, the total eradication of Malaria in Nigeria should be the ultimate goal and efforts should be targeted in that direction.