The fight against malaria, one of the world’s worst diseases for decades, is likely to get much easier as the World Health Organization has endorsed the wide use of a malaria vaccine developed by GlaxoSmithKline, the first ever to win such approval. The vaccine will be recommended for children in sub-Saharan Africa and other high-risk areas as a four-dose schedule starting at age 5 months.
“This is a historic moment. The long-awaited malaria vaccine for children is a breakthrough for science, child health and malaria control,” said WHO Director-General Tedros Adhanom Ghebreyesus in a statement announcing their endorsement of the vaccine. “Using this vaccine on top of existing tools to prevent malaria could save tens of thousands of young lives each year.”
Despite the good news, GlaxoSmithKline’s vaccine, which is currently code-named RTS,S/AS01 but will be branded as Mosquirix, is only modestly effective. In the clinical trials evaluated for WHO approval, it was found to prevent around half of severe cases caused by P. falciparum malaria, compared to the control group. But this level of efficacy was only seen in the first year of vaccination, and by the fourth year, protection had waned to very low levels. At roughly 55% efficacy, the vaccine meets the bare minimum for WHO endorsement.
A major study this year did find that a combination of the vaccine and anti-malarial drugs can further reduce the risk of severe disease and death by 70%, a much more appealing target for public health programs. But even as is, one study has projected that the vaccine would prevent millions of cases and over 20,000 deaths annually in sub-Saharan Africa if deployed widely.
Like other vaccines before it, Mosquirix may also represent the first step toward more effective vaccines in the future. There are several other candidates in development already, including one from Moderna that’s relying on the same mRNA platform as the company’s successful covid-19 vaccine.