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Understanding the African malaria problem

Malaria killed more than 600,000 people in 2020, according to a WHO report, with Africa being home to 95% of cases. The approved RTS,S vaccine could help change that.

The approval of the world’s first malaria vaccine RTS,S is a major breakthrough in the fight against a disease predominantly affecting African citizens.

This new vaccine could help save tens of thousands of young children, and requires four doses given after five months of age.

WHO Director-General Dr Tedros Adhanom Ghebreyesus described the news as historic, explaining that ‘the long-awaited malaria vaccine for children is a breakthrough for science, child health, and malaria control.’

Since 2019, an immunization pilot program in Kenya, Ghana, and Malawi has been underway, with more than 2.3 million doses being administered to children in moderate to high transmission regions.


The Malaria challenge in Africa

Africa faces a higher risk of malaria infections than the rest of the world, despite the disease being preventable and curable.

According to WHO’s recent reports, an estimation of 241 million cases were reported in 2020. Globally, malaria caused 627,000 deaths in 2020. Africa accounts for 95% of all cases and 96% of total deaths.

Children are the most vulnerable group, accounting for 80% of deaths in sub-Saharan Africa. The rise in the number of infections and deaths was due to Covid-19.

The most affected countries are Nigeria, Democratic Republic of Congo, Tanzania, and Mozambique, which account for over half of the total malaria deaths.

Pregnant women remain vulnerable and are prone to mosquito bites especially in remote regions in Africa. In 2019, WHO estimates that over 12 million pregnancies were exposed to malaria, resulting in fetal loss, low birth weights, and other morbidities.

When discussing malaria control in sub-Saharan Africa, one must take into account regional challenges that can cause extra stresses and complications.

For one, the disease is closely associated with poverty. Malaria thrives mostly in regions with poor living conditions that foster the breeding of the mosquito vectors, and among people with poor socio-economic conditions that prevent them from accessing quality healthcare.

Additionally, sub-Saharan Africa is located in a region with a climate suitable for the reproduction and propagation of the female anopheles mosquito.

While the reason for the preponderance of malaria in this region is not limited to this, climatic conditions characterized by high temperature and abundant rainfall of sub-Saharan Africa play a major role in this disease.

Most sub-Saharan Africa countries lack the governmental support required for effective control of malaria.

Without judicious policies to safeguard against financial corruptive practices, most control strategies put in place invariably lose potency over time.

In addition to this, the health system in sub-Saharan Africa is characterized by limited access to medical services and products, lack of human resources for health, shortage of functioning health facilities, and an overall lack of quality healthcare service delivery.


Curbing malaria

Several measures have been in place for decades to try and control malaria.

From clearing bushy areas, to sleeping under insecticide-treated beds, these measures are less successful in poverty stricken areas of sub-Saharan Africa. Recently, China joined the 40 countries declared malaria-free by the WHO, making it the first country in the WHO Western Pacific Region to be awarded the certification.

The malaria vaccine mass roll-out is expected to begin by the end of 2022. The British GlaxoSmithKline (GSK) pharmaceutical giant said it would provide at least 15 million doses a year.

Taking into account the annual number of infections, the doses required could go up from 80 million to 100 million to fully reach the most affected regions.

Last week, the Gavi Alliance Board approved an investment of $155.7 million dollars for 2022-2025 to support the introduction, procurement, and delivery of vaccines to sub-Saharan Africa countries.

Let’s wait and see the progress in the near future.

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