The World Health Organization approved yesterday, in a historic move, the use of a malaria vaccine. The announcement comes after two years of a pilot program carried out in Ghana, Kenya and Malawi, in sub-Saharan Africa, the area of the world where the disease is most deadly and where more than 2.3 million doses of the vaccine have been applied since 2019, in more than 800,000 children who received at least one dose.
The RTS,S / AS01 vaccine or Mosquirix, as its trade name is known, was manufactured by GlaxoSmithKline Pharmaceuticals and was shown to have an average effectiveness of 40% in children as young as five months. While its efficacy declined after one year, the safety profile was deemed acceptable.
"This is what we have learned: it is safe, it significantly reduces severe forms of the disease, and it has a broad reach for children, including the most vulnerable," was the assessment given by WHO director general Dr. Tedros Adhanom.
Malaria is a disease caused by a parasite that invades and destroys blood cells to reproduce and is transmitted by mosquito bites.
Medications to kill the parasite, bed nets to prevent bites and insecticides to eliminate the mosquito have helped reduce malaria, but it has not been enough.
The largest number of cases are in Africa, where more than 260.000 children died from the disease in 2019.
After 10 to 15 days after the bite, people begin to feel intense fever, excessive sweating, severe coughing, diarrhea and general malaise. In the most severe cases, people may convulse, go into a coma and even die.
The pilot conducted on the African continent showed that with the administration of 2.3 million doses of the vaccine, there was a reduction of up to 30% in severe malaria. In addition, there was no negative impact on other routine vaccines or other measures to prevent malaria.
"From a scientific perspective, this is a major breakthrough, from a public health perspective, it's a historic feat", said Pedro Alonso, director of WHO's Global Malaria Program.
"We have been looking for a malaria vaccine for more than 100 years, it will save lives and prevent disease in African children", he added.
The delayed vaccine finding vs. the Covid-19 vaccine.
Unlike the Covid-19 vaccine, which was developed in record time in less than a year, many people wonder why the malaria vaccine has taken so long to be approved, and in the end has a lower efficacy rate than the coronavirus vaccine.
The first thing to understand is that malaria is caused by a parasite that is much more insidious and sophisticated than the virus that causes Covid-19. It is a disease that within the human body takes different forms as it infects liver cells and red blood cells.
The malaria parasite has evolved to evade the immune system and that is why a person must contract malaria over and over again before they begin to get limited protection.
Developing a malaria vaccine is more complex, as this parasite has different mutations. The RTS only targets the sporozoite form of the parasite, which is the stage between a mosquito bite and the parasite reaching the liver. This is why the vaccine is only 40% effective.
However, this result is still a remarkable success and paves the way for the development of even more potent vaccines.
35 years after the vaccine
Manuel Elkin Patarroyo Murillo is a Colombian immunologist who has been working for 35 years to develop a vaccine against malaria.
Colombian journal El Tiempo spoke to Patarroyo, who said he was not happy with the WHO approval, as he claims that his vaccine is 80% effective and is already in stage three of confirmation.
"I find it sad that a vaccine with 36 percent efficacy has been approved by the WHO when ours -which was the first synthetic vaccine in the world- 35 years ago had higher levels of protection, it is something I do not understand. Had it been authorized, its massive use would have prevented thousands of deaths", said Patarroyo.