Children’s malaria vaccine milestone in the fight against malaria

Last week, the World Health Organization (WHO) recommended the use of the malaria vaccine RTS,S/AS01 (RTS,S) for children in Sub-Saharan Africa and other areas where malaria is prevalent. This malaria vaccine has been used since 2019 in research with 800,000 children in Ghana, Kenya and Malawi.

The World Health Organization (WHO) calls it a ‘historic moment’ and a ‘breakthrough for science’. WHO Director-General Tedros Adhanom Ghebreyesus points out that tens of thousands of young lives are saved every year with this vaccine. Malaria is one of the leading causes of infant mortality in Sub-Saharan Africa. More than 260 thousand African children under the age of five die from malaria every year. The malaria vaccine RTS,S, also called Mosquirix, works against P. falciparum, the malaria parasite most prevalent in Africa and causing the deadliest form of malaria.

Resistance

Internist-infectiologist Meta Roestenberg (LUMC) and involved in the development of another malaria vaccine calls the decision to use RTS,S a ‘milestone’ in the fight against malaria. “It is really a huge achievement. It gives us, all scientists and stakeholders, energy. Many people have been doing it for years. Some were concerned it would never happen, but now we have a vaccine.’ In recent years, the WHO has reported stagnating progress against the deadly disease. ‘For years, the number of malaria deaths was reduced little by little, Roestenberg admits, ‘but in recent years this has indeed stopped. Given the parasite’s increasing resistance to the available drugs, we were concerned that we were losing control.’

Enorme impact

The research shows that the use of the vaccine means a 30 percent reduction in severe malaria. “That means we’re not there yet. At the same time, you can see that it has a huge impact. So far, just under half a million children die from malaria every year, and on that scale, 30 percent is quite an achievement. This vaccine is now part of the various means at our disposal, such as mosquito nets.’

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The search for additional and new malaria vaccines continues. ‘This drug targets one malaria protein, which is switched off. But that is also the weak spot, variants can arise that make the vaccine less effective.’ Roestenberg himself is involved in developing a vaccine that Radboudumc and LUMC are working on, with a genetically weakened, live parasite. “For me, it’s an impulse to keep going. There is not yet a vaccine that works more broadly.’ The internist-infectiologist heads the Leiden Controlled Human Infection Center, where a clinical study is currently underway into this malaria vaccine.



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