According to the World Malaria Report 2020, malaria kills almost half a million people every year. Up until now, the primary way to prevent malaria has been through mosquito nets. But the tide might be turning in the fight against this deadly disease. Recently, the World Health Organization (WHO) recommended the first-ever malaria vaccine.
What is malaria and why does a vaccine matter?
Malaria is caused by parasites spread through the bites of infected mosquitos. Symptoms usually appear 10 to 15 days after a bite and include fever, chills, nausea and headaches. Because these symptoms are so common, it can be hard to recognize in its early stages.
In general, if diagnosed early, malaria is treatable. The treatment can be as simple as taking a few anti-malarial pills. But if treatment is not begun quickly, malaria can progress to severe disease and even death. Severe disease can cause seizures, anemia, and inflammation in the lungs that makes it hard to breathe.
Much of the world’s population is at risk of malaria. But people living in sub-Saharan Africa shoulder the burden of disease. According to the WHO, 94% of malaria cases and deaths occur in Africa. And children are the most at risk. More than half of all malaria deaths are among children under five in sub-Saharan Africa.
For people who lives in areas with high malaria rates, the threat is constant. Malaria can strike the same person over and over. In fact, children in sub-Saharan Africa suffer an average of six bouts of malaria per year. Even if the disease is not fatal, it can leave children weak and vulnerable to other illnesses.
The tragedy is that malaria is both preventable and treatable. Until now, the primary prevention method has been mosquito nets. Along with mosquito nets, the malaria vaccine would be a powerful weapon in preventing this deadly disease.
What a vaccine would mean to Suzanne
A malaria vaccine would ease the worry of mothers like Suzanne. Suzanne knows all too well the threat of malaria. At 33 years old, she is a mother of eight. She’s also a refugee living in the Nyarugusu Refugee Camp in Tanzania. Suzanne’s family lives near a swamp, which is a breeding ground for mosquitos. Every one of Suzanne’s children has suffered from malaria.
Suzanne’s family sleeps under mosquito nets, but their nets have holes. Mosquitos can easily get inside while they are sleeping. One of Suzanne’s children, Rwamba Isaya, was five months old when he got malaria. He had a fever and diarrhea, so Suzanne took him to a nearby clinic. There, he received medicine. But the medicine didn’t work. Rwamba grew sicker until he started convulsing – the malaria had reached his brain. There was nothing more doctors could do and soon, Rwamba was gone.
Devastated, Suzanne returned home with empty arms. She burned all his clothes. It was too painful for her to see them and remember the son she’d lost.
Suzanne carries the grief of losing a child. And she lives with the daily fear of another one of her children getting sick. “I have reason to worry,” she explains. “If you stay the night, you’ll see how many mosquitos bite.”
The development of the malaria vaccine
The scientific community has been working to develop a vaccine to prevent malaria for decades. But none of the vaccines have ever made it beyond clinical trials until now.
“This is a vaccine developed in Africa by African scientists and we’re very proud,” says WHO Director-General Tedros Adhanom Ghebreyesus. “Using this vaccine in addition to existing tools to prevent malaria could save tens of thousands of young lives each year.”
This innovative vaccine is the first successful vaccine against malaria. And it’s also the first vaccine developed to combat parasitic illness. It helps fight off the deadliest malaria parasite, called Plasmodium falciparum.
The WHO is recommending the vaccine for use in children five months and older – children like Rwamba. They are encouraging its use in regions like sub-Saharan Africa with moderate to high malaria transmission. According to one modeling study, it could prevent 23,000 deaths a year in children under five.
Some say it is too soon to tell what impact it will have on the rate of death. The effectiveness of the vaccine is moderate, preventing about 30% of severe cases after a series of four injections. Others argue some protection through vaccination is better than none. Ashley Birkett, who leads efforts to develop a malaria vaccine for the non-profit, PATH, says, “This is how we fight malaria, layering imperfect tools on top of each other.”
There is still a long road ahead for the vaccine. Each country’s ministry of health will need to decide whether to use the vaccine as part of their malaria control strategy. Manufacturers will have to step up mass production and distribution — a tall order during the COVID-19 pandemic. Finally, the global health community will need to secure funding and vaccine stocks to roll it out more widely.
Despite those challenges, this vaccine is being heralded as a historic breakthrough. It is providing a glimmer of hope for hundreds of thousands of people like Rwamba who suffer and die from malaria every year.
Our work to prevent and treat malaria
Medical Teams has been on the front lines of this fight. We are working hard to prevent and treat malaria in people like Suzanne and her children. Our staff in Uganda, Tanzania and Sudan see hundreds of cases every day. Until there is a vaccine, what does prevention and treatment look like now?
It looks like helping distribute mosquito nets. Sending Community Health Workers out to check on families. Teaching about disease symptoms and referring people to local clinics.
It also looks like equipping those clinics with malaria tests, medicine and medical supplies like IV fluids.
Our staff work day and night to keep children alive. But sometimes, for babies like Rwamba, the disease has progressed too far. Sometimes treatment is not enough.
Dr. Joy Wright, Medical Teams Health Advisor, has seen the effects of malaria on children in places like Myanmar and Uganda. “The kids you remember are the really unwell ones — for me, that’s a young boy I looked after in Myanmar who had cerebral malaria and sadly didn’t survive,” she says. Dr. Joy calls this vaccine a “major milestone” but says ultimately the vaccine will only change outcomes if it reaches the people who need it most. And that will take years of commitment and work from funding bodies, governments, manufacturers and health agencies like Medical Teams.
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