By: Willemien Jansen (Copy and Content Editor)
The Southern African Development Community (SADC) commemorates Malaria Day on 6 November with the aim "create awareness about malaria and mobilise the community to participate in malaria control programmes".
The World Health Organization (WHO) defines malaria as a "life-threatening disease caused by parasites that are transmitted to people through the bites of infected female Anopheles mosquitoes". Even though malaria is a preventable and curable disease, malaria is one of the six major causes of death from communicable diseases globally, and 90% of the world's approximate 440 000 annual malaria deaths occur in Africa. The National Institute for Communicable Diseases (NICD) further state that from 2015 – 2019, South Africa has had between about 10 000 and 30 000 notified cases of malaria each year.
These numbers are very concerning, especially in light of possible co-infections of COVID-19 and malaria. However, news of a new vaccine against malaria has brought some hope, especially for developing nations. The vaccine was approved for use by the WHO in October of this year. The WHO especially recommends the vaccine to children under the age of five in sub-Saharan Africa, since more than 260 000 children die annually from malaria in this region. The WHO and its partners have reported stagnation in the progress against this deadly but preventable disease, and there is no time like the present to kick efforts against this disease into gear. The results from the two-year wider pilot (after the initial pilot study that was took place six years ago) study in Ghana, Kenya and Malawi yielded many positive results, including a reduction (30%) in cases of deadly severe malaria in children. Modelling also estimates that the vaccine will be cost-effective in areas of moderate to high malaria transmission.
Practically speaking, a reduction of 30% of severe cases might seem low, however when the scope of the problem and the high mortality rate of malaria is taken into account, 30% is a significant number of people. Studies have also shown that the vaccine prevents 40% of overall malaria cases. Unfortunately, this is not the cure that many had hoped for, and health authorities are keen to stress that the vaccine should be used alongside other preventative measures, treated net beds and existing malaria drugs.
Other factors that need to be considered are costs, infrastructure and distribution. The vaccine is manufactured by GlaxoSmithKline (GSK), which has pledged to supply the vaccines at manufacturing cost plus 5%. It will be up to individual countries to come up with the money through donor funding. These discussions seem to be ongoing. GSK will continue to donate vaccines for the pilot programmes in Ghana, Kenya and Malawi, and has donated 10 million doses to the study so far. The company has committed to donating 15 million doses a year, but there are concerns that this might not be enough for wider use if funding isn't procured for additional doses. The vaccine is administered to children under the age of two and can be bundled with other immunisation programmes. More public education will be necessary and healthcare workers will have to receive training on the vaccine.
The malaria parasite has a very complex lifecycle, which has caused serious delays in the development of vaccines for more than three decades. Even though the vaccine from GK is far from the cure that the world is hoping for, the successes from its trial provides some hope for future breakthroughs, and many saved lives.
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