Following the WHO’s endorsement last week of the world’s first Malaria vaccine RTS,S/AS01 (RTS,S) recommending its broad use for children in sub Saharan Africa and other regions with moderate to high malaria transmission risks, the Sunday Observer asked Consultant Epidemiologist, Epidemiology Unit, Ministry of Health, Dr Deepa Gamage if this could have any impact on Sri Lanka’s current status as a Malaria eliminated country.
In reply she said, “Sri Lanka is not a high endemic country and still remains as a Malaria eliminated state, which means free of malaria in country transmission with high burden. The health infra-structure with the Malaria Control Program however is fully vigilant in early detection and ready to rapidly respond for any imported cases.” she said.
Explaining how the vaccine program operated in the pilot countries where it was first tested on over 8000 children, she said, “The Malaria vaccine is under a pilot vaccination, in 3 countries Ghana, Kenya, Malawi due to these countries suffering from high transmission of malaria especially affecting children. The vaccine labelled as RTS,S/AS01 (RTS,S) was developed to use against the common malaria causing parasite in most African countries “Plasmodium Falciparum”. The pilot countries provided the vaccine in a schedule of 4 doses to children from 5 months of age for the reduction of malaria disease and burden.”
To our query regarding the results of the vaccine administered in the three pilot countries on the target child population, she said, “It has shown a significant reduction of life-threatening severe malaria and in paediatric hospitalisation with malaria infection in childhood with severe cases. The pilot vaccine administration continued in these countries since 2019, and on October 6 , the WHO recommended to go beyond the pilot administration out of these countries to countries which have moderate to high transmission as defined by WHO to protect children from P. falciparum disease causing deaths.”
Asked whether the vaccine would be available to children in Sri Lanka as well, she said, “The WHO recommendation of malaria vaccine for wide spread use doesn’t mean it is fully registered based on the process of “WHO-pre qualification” procedure and available for all the countries. However, based on evidence received from the pilot countries on safety profile of the vaccine, feasibility of implementation, vaccine acceptance, effect of protecting children in high P. falciparum endemic countries, two global scientific advisory bodies recommended its approval from WHO to use it in other high endemic countries, as categorised by WHO with high malaria transmission .”
Responding to another query by Medisnip whether the WHO recommendation to high endemic countries to consider malaria vaccine was also a part of comprehensive National malaria control strategies with regard to child mortality due to P. falciparum malaria and how safe it was, she said , “The RTS,S malaria vaccine is the first malaria vaccine use in these pilot countries which has completed the clinical development process .
It is the result of 30 years of research including different partner organisations and today has shown results while continuing to gather more evidence on the long term success. It has also received a positive scientific opinion from the European Medicines Agency (EMA), which is considered as a stringent regulatory authority. This is the first malaria vaccine introduced through the childhood immunization programs in 3 pilot countries of Ghana, Kenya and Malawi for more than 800 000 children and showed an added benefit in protecting children”.