What is the new anti-malaria vaccine cleared by WHO all about? Will it work for India?
Vaccine, meant for plasmodium falciparum, expected to be affordable
The WHO says the new vaccine, R21/Matrix-M, will address a shortfall that its earlier version, RTS,S, could not address. (Reuters) The World Health Organisation (WHO) has pre-qualified a malaria vaccine developed by the Oxford University and Serum Institute of India (SII), which is expected to rein in the disease that’s not just a global problem but also affects India every season. It fights the disease-causing parasite falciparum. This is the second malaria vaccine to be approved.
SII will manufacture 100 million doses a year and is expected to double its manufacturing capability in the next two years, with most of the vaccines meant for high-endemic countries in Africa. Malaria is a mosquito-borne disease caused by a parasite that can affect the brain and respiratory system and turn life-threatening if not promptly treated. Globally, it led to 247 million cases and around 6,19,000 deaths in 2021.
What do we know about the vaccine?
Trials have proven its safety and effectiveness as it reduced symptomatic malaria cases by 75 per cent in areas where there is a high seasonal prevalence and by 68 per cent in areas where the disease circulates all year round. It uses the same adjuvant — an ingredient that boosts your immune response — as the COVID-19 vaccine, Novavax, a version of which was also rolled out by SII.
The vaccine, which is meant for children under the age of five years, has three primary doses and a booster shot after a year. Since this vaccine is specific to plasmodium falciparum, it cannot be used to prevent infections caused by other malaria parasites like plasmodium vivax, which is known to persist in the liver and trigger repeated infections. Vivax is fairly widespread in India and there is no vaccine yet to tackle it.
Will the vaccine become available in India?
No. At present, it is meant for high-burden countries in Africa, where most of the cases are caused by falciparum. The burden of falciparum in India is already on the decline, the main concern being vivax. That’s why many experts believe that a wide use of vaccines against falciparum might not be cost-effective.
Why is the vaccine needed?
The WHO says the new vaccine, R21/Matrix-M, will address a shortfall that its earlier version, RTS,S, could not address. Dr Tedros Adhanom Ghebreyesus, WHO Director-General, said: “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.”
How much will the vaccine cost?
Since it can be manufactured on a mass scale, costs are expected to be modest.
What is the current scenario in India?
Malaria incidence has reduced by 60 per cent between 2018 and 2022, with the decline in falciparum cases from high-burden states such as Odisha. “India has made impressive progress towards malaria elimination and has contributed significantly to the decline in malaria burden in the WHO South-East Asia Region. However, it still contributed 79 per cent of the WHO-estimated caseload of 5.4 million cases in the region in 2021,” says Dr Neena Valecha, former WHO Regional Advisor (Malaria). “Plasmodium falciparum still accounts for 57 per cent of all cases. Plasmodium vivax is the predominant species in states closer to malaria elimination, particularly in urban areas,” she adds. Besides, most patients are above five years of age.
How can India eliminate malaria by 2030?
It needs to implement existing protocols as a new framework for elimination is being drawn up. “Investing in insecticidal nets, better reporting and ensuring compliance to the 14-day regimen for the vivax infections are still a challenge. So, getting resources for a vaccination drive is unlikely,” says Pratik Kumar from Prayatna, which runs programmes on malaria elimination in Odisha.
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