R21/Matrix-M. It is the new pediatric malaria vaccine unveiled on Oct. 2, 2023, by the World Health Organization (WHO) and licensed for malaria control in children aged 6 months/5 years.
Malaria is on the rise everywhere in the tropic in the post Covid years. Cases are increasing but child mortality from malaria is also increasing again, particularly in the Sub Sahel area of Africa. About 20 years ago, awareness began in many African countries of the use of permethrin-treated mosquito nets to prevent mosquitoes from biting children and adults at night, during sleep. And the effectiveness of this simple tool was not long in manifesting itself with an excellent decrease in cases.
Today, in the era of new vaccines, the prospects of fighting the disease are changing, although there is still a long way to go.
Two years ago a first malaria vaccine, the RTS-S (Mosquirix) vaccine was approved and put on the market starting in Ghana. In two years, this new vaccine, which should be considered a true lifesaver, has demonstrated more than 75 percent efficacy. Early data on the vaccine’s use show that the long-standing fight against malaria has taken a big step forward. It is noteworthy that the vaccine is made and marketed for the pediatric population between the ages of 6 months and 5 years. A vaccine designed to significantly affect infant mortality.
This pediatric vaccine has been produced by GlaxoSmithKline Biologicals since 2021, the year of commercialization, and has been used specifically in Burkina Faso, Gabon, Ghana, Kenya, Malawi, Mozambique, and Tanzania. By 2025, the pharmaceutical company plans to produce and deliver 18 million doses destined for 12 African countries.
The sentence spoken by WHO Director-General Tedros Adhanom Ghebreyesus highlights the level of achievement in prevention that we have reached: “As a malaria researcher, I dreamed of the day when we would have a safe and effective vaccine against malaria. Now we have two.”
It should be noted that since the first RTS-S vaccine was put on the market, requests to obtain vaccine doses have far exceeded the supply of the manufacturer. The advent of a second vaccine is intended to cover the undoubtedly huge demand coming from most countries in the tropical region.
The R21/Matrix-M will be produced by the Indian pharmaceutical company “Serum Institute of India,” which is the largest vaccine producer in the world. The production capacity of the new vaccine will be 100 million doses per year, which in the next two years apparently will be increased to 200 million doses per year.
The two recent malaria vaccines both target the pediatric population and have demonstrated the safety and efficacy necessary for widespread vaccination practice.
The new R21/Matrix-M vaccine has been shown in tests to be more than 75 percent effective, when administered just before the wet and rainy season. Three doses are to be administered to achieve maximum coverage and reduction in infant mortality. The price set for the R21 /Matrix-M vaccine is between two and four U.S. dollars per dose.
Map of malaria in the world (Courtesy WHO-WHO)
These are the numbers of malaria in the world before Covid-19.
In the post-Covid era these numbers have undergone a major increase:
– 229 million estimated malaria cases globally;
– 87 countries where the disease is endemic;
– Over 400,000 deaths from malaria;
– 274,000 children under the age of 5 who died from malaria 67 percent of the total;
– 215 million (94 percent) children affected by malaria on a global basis;
– 95% of deaths occurred in 29 African countries.
– 6 African states had more than 50 percent of malaria deaths.
– Nigeria 23%;
– Congo-K (DRC) 11 percent;
– Tanzania 5%;
– Mozambique 4%;
– Niger 4%;
– Burkina Faso 4%.
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