18 million doses: Uganda among 12 African nations to get first-ever malaria vaccine

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By early 2024, Uganda and eight other African countries are expected to start rolling out their first doses of the first-ever malaria vaccine, a joint statement by World Health Organisation (WHO), Gavi and UNICEF has said.

The plan is that the vaccines will have arrived during the last quarter of this calendar year (between October and December).

Already, the malaria vaccine (RTS,S/AS01) has been administered to over 1.7 million children in neighbouring Kenya, Malawi and Ghana.

And since being rolled out in those three African countries four years ago (2019), the vaccine has been shown to be "safe and effective", according to WHO, and has resulted in both a "substantial reduction in severe malaria and a fall in child deaths".

Now, nine countries on the continent, including Uganda, will also introduce the vaccine into their routine immunization programmes for the first time.

The vaccine is developed and produced by GSK, a global biopharma company. 

A joint press statement released by WHO on Wednesday said a total of 18 million doses of RTS,S/AS01 have been allocated to a dozen African countries, including the pioneer three, over the next two years (2023 to 2025).

Besides Uganda, the other eight new beneficiaries are DR Congo, Burundi, Benin, Burkina Faso, Cameroon, Liberia, Niger and Sierra Leone.

The rollout is being seen as a "critical step forward" in the fight against malaria.

Malaria is one of Africa’s deadliest diseases, killing nearly 500,000 (half a million) children under the age of five, according to official data.

The disease accounts for about 95% of global malaria cases and 96% of deaths in 2021.

Since 2019, Ghana, Kenya and Malawi have been delivering the malaria vaccine through the Malaria Vaccine Implementation Programme (MVIP), which is coordinated by WHO and funded by Gavi, the Vaccine Alliance, the Global Fund to Fight AIDS, Tuberculosis and Malaria, and Unitaid. 

Mothers listen to the instructions of the vaccination during the launch of the extension of the world’s first malaria vaccine pilot programme in Gisambai, Kenya on March 7, 2023

A health surveilance assistant civic educates a mother before giving her child a dose of malaria vaccine at Mitundu Community hospital in Lilongwe, Malawi on April 23, 2019

A nurse of Ewin Polyclinic administers the malaria vaccine to a baby at Pempamsie Hotel, Cape Coast, Ghana, on April 30, 2019

At least 28 African countries are understood to have expressed interest in receiving the malaria vaccine.

The latest allocation round that includes nine new beneficiaries "makes use of the supply of vaccine doses available to Gavi, Vaccine Alliance via UNICEF", according to WHO.

The countries that have been prioritized for the limited malaria vaccine supply are those where the risk of malaria illness and death among children is highest.

This is as per a framework that was developed in 2022 by a group of expert advisors, primarily from Africa, where the burden of malaria is greatest.

The burden of malaria is greatest in Africa

'Life-saving advancement'

According to WHO, annual global demand for malaria vaccines is estimated at 40–60 million doses by 2026 alone, growing to 80–100 million doses each year by 2030. 

Gavi has recently outlined its roadmap to support increasing supply to meet demand.

In addition to the RTS,S/AS01 vaccine, it is expected that a second vaccine, R21/Matrix-M, developed by Oxford University and manufactured by Serum Institute of India (SII), could also be prequalified by WHO soon. 

“This [RTS,S/AS01] vaccine has the potential to be very impactful in the fight against malaria," Thabani Maphosa, the managing director of country programmes delivery at Gavi, the Vaccine Alliance, is quoted as saying in Wednesday's joint press statement.

He adds that when broadly deployed alongside other interventions, the vaccine can prevent "tens of thousands of future deaths every year".

On her part, UNICEF's associate director of immunization, Ephrem T Lemango, says the roll-out of this malaria vaccine "will give children, especially in Africa, an even better chance at surviving".

Adding: "As supply increases, we hope even more children can benefit from this life-saving advancement".

Dr Kate O’Brien is the WHO director of immunization, vaccines and biologicals. She says the malaria vaccine is "a breakthrough to improve child health and child survival".

"This first allocation of malaria vaccine doses is prioritised for children at highest risk of dying of malaria,” she is quoted as saying.

"The high demand for the vaccine and the strong reach of childhood immunisation will increase equity in access to malaria prevention and save many young lives. 

"We will work tirelessly to increase supply until all children at risk have access.”