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WHO Recommends old GSK Malaria Drug for Africa

07.10.2021 - The World Health Organization (WHO) has recommended administering GlaxoSmithKline’s 33-year-old malaria vaccine to children across Africa in the hope of stalling the spread of the mosquito-borne disease. Despite a preceding positive recommendation the European Medicines Agency (EMA) in 2015, the vaccine still is not in widespread use.

The WHO made its recommendation after the vaccine, which is clinically known as RTS,S and also goes by the brand name Mosquirx, showed positive results in a pilot program in Ghana, Kenya and Malawi. There, it is said to have cut malaria cases by 40% and reduced hospitalizations of the potentially deadly disease by nearly a third.

”This is a historic moment,” WHO director general Tedros Adhanom Ghebreyesus said following a meeting of the organization’s vaccine advisory committee, which made the recommendation based on results from ongoing research in Ghana, Kenya and Malawi that has tracked more than 800,000 children since 2019.

GSK said doses will be distributed to children in sub-Saharan Africa and other areas with moderate to high levels of malaria transmission. Specifically, the WHO is recommending a four-dose course of the vaccine starting at five months of age to help protect against Plasmodium falciparum malaria and to lower the overall disease burden.

How will distribution be financed?

In anticipation of the UN health agency’s decision and a wider rollout beyond the pilot programs, the UK-based drugmaker said it has begun working with partners “to develop solutions to provide equitable and long-term access to the vaccine.” At present, it is not clear who will pay for the rollout, and some commentators said they were skeptical that wide distribution would be possible in few of the problems pointed up by the Covid vaccine experience.

For its part, GSK said it has committed to donate up to 10 million doses for use in the pilot schemes, and will supply up to 15 million additional doses at no more than 5% above cost of production. The company said is working with India’s Bharat Biotech on product-  and technology transfer for long-term antigen production and also will work closely with partners, funders and governments to support additional supply.

Developed in 1987, GSK’s is the only vaccine authorized for malaria to date. Although it reportedly has an efficacy rate of only 30-40%, requires up to four doses, and  its protective effect wanes after only a few months, the WHO’s Africa director Matshidiso Moeti said the recommendation nevertheless offers a “glimmer of hope” for the continent that shoulders the heaviest burden of the disease.

Some scientists commenting on the decision said that they thought the vaccine, even with deficiencies, could still have a major impact in Africa, where the majority of the world’s more than 200 million cases a year and 400,000 deaths occur.

“This is a huge step forward,” Julian Rayner, director of the Cambridge Institute for Medical Research, commented. “It is an imperfect vaccine, but it will still stop hundreds of thousands of children from dying.”

Rayner pointed to the Covid vaccines as an encouraging example. “The last two years have given us a very nuanced understanding of how important vaccines are in saving lives and reducing hospitalizations, even if they don’t directly reduce transmission,” he remarked.

Sian Clarke, co-director of the malaria center at the London School of Hygiene and Tropical Medicine, said the vaccine would be a useful addition to physical tools such as bed nets and insecticides. Over the past few years, little significant progress has been made against malaria, he noted.

Author: Dede Williams, Freelance Journalist

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