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The World Health Organization has recommended approval of a malaria vaccine made by Oxford university that has shown sustained protection in trials, marking a turning point in the treatment of a disease that continues to kill hundreds of thousands of children each year.
Tedros Adhanom Ghebreyesus, the WHO’s director-general, said on Monday the health body was recommending a second vaccine for widespread use in preventing malaria in children at risk of the disease.
The approval of R21/Matrix-M adds a highly effective shot to the range of treatments for malaria, one that can be rolled out on a wide scale to countries in sub-Saharan Africa that need it the most as a result of Oxford’s manufacturing agreement with the Serum Institute of India (SII).
“As a malaria researcher, I used to dream of the day we would have a safe and effective vaccine against malaria. Now we have two,” Tedros said.
“At a cost of $2-$4 a dose it’s comparable to other malaria interventions and other childhood vaccines,” he said, adding the decision was based on input from the WHO’s strategic advisory group of experts on immunisation and its malaria policy advisory group. They reviewed evidence that showed the shot reduced symptomatic cases by 75 per cent in the year after three doses of the vaccine, with a fourth dose shown to maintain protection.
The shot uses an adjuvant made by US drugmaker Novavax to boost its efficacy by enhancing the body’s immune response. Regulators in Ghana were first to approve it earlier this year. The WHO recommended the GSK-produced RTS,S/AS01, which Tedros said showed similar efficacy to the Oxford shot, for widespread use in 2021.
Malaria, which is caused by parasites transmitted by mosquitoes, remains a significant global health threat, especially in Africa, which in 2021 was home to 95 per cent of cases and 96 per cent of a global total of over 600,000 deaths. Children under 5 accounted for four-fifths of all deaths in the region. The disease is both preventable and curable, though more than 240mn cases worldwide were recorded in 2021.
R21 targets the parasite in its early stages, just after it has come into contact with the human body. A study published last year showed that a booster dose of the R21 vaccine showed efficacy as high as 80 per cent in one group, and 70 per cent in the other.
R2 could be supplied in bigger volumes due to Oxford’s production arrangement with SII, experts have said.
“Demand for malaria vaccines is unprecedented; however, available supply of RTS,S is limited,” the WHO said on Monday. “The addition of R21 to the list of WHO-recommended malaria vaccines is expected to result in sufficient vaccine supply to benefit all children living in areas where malaria is a public health risk.”
