By Punch Editorial Board
The world erupted in elation recently after the World Health Organisation approved the use of the world’s first malaria vaccine RTS, S/AS01 (RTS, S). The United Nations agency recommended the use of the vaccine in countries with moderate to high malaria transmission, particularly sub-Saharan Africa, where the disease is a primary cause of childhood illness and death. For Africa, the most malaria-impacted continent, the breakthrough raises great hope.
Before the WHO reached the landmark decision, it based it on the cheering results from a pilot project in Ghana, Kenya and Malawi that targeted over 800,000 children. Malaria, the agency has variously noted, is a life-threatening disease caused by parasites transmitted to sufferers through the bites of infected female anopheles mosquitoes.
In 2018, there were 228 million cases of malaria worldwide, leading to 411,000 deaths, and 229 million cases and 409,000 deaths in 2019, mostly in sub-Saharan Africa. The World Malaria Report 2020, published by the WHO, said that only six countries accounted for about half of malaria deaths worldwide, with Nigeria at 23 per cent topping the list. The agency’s reports indicated that African children under five are the most vulnerable to malaria. In 2019, this group accounted for 67 per cent (274,000) of malaria deaths globally.
Strikingly, the development of the vaccine took 100 years, which makes it really an extraordinary scientific achievement. Thus, this discovery undeniably offers an opportunity for Nigeria to defeat the malaria-bearing parasite, which has become drug-resistant. It needs to see the breakthrough as a tool to combat malaria frontally through innovation.
Nigeria should speedily key into the vaccine supply chain reasonably ahead of other contending African countries, given its alarming malaria burden. It is bountiful hope for Nigeria and its citizens based on the WHO Director-General, Tedros Ghebreyesus’ description of the discovery as “a historic moment” and the long-awaited vaccine as “a breakthrough for science, child health and malaria control.”
Before the vaccine breakthrough, only four out of the 47 countries comprising the WHO Africa region had conquered malaria. They are Algeria, Mauritius, Lesotho, and Seychelles. All six countries that in 2019 accounted for half of the malaria deaths are in Africa; led by Nigeria, others are Congo DR, Tanzania, Burkina Faso, Mozambique, and the Niger Republic. This is disheartening, and Nigeria has no reason not to join other serious countries who, having achieved three consecutive years of zero indigenous cases, applied for a WHO certification of malaria-free status. Every country in that category is eligible to do so.
Nigeria can no longer fold its arms and watch feebly as malaria kills its population, notably infants. The vaccine innovation did not come from its medical researchers despite the country’s embarrassing global status of malaria burden and the concerned authorities must be up and doing in pragmatic research to tackle diverse diseases in the country.
It should fully take advantage of the vaccine by further investing heavily in research and rousing its sleepy research agencies, especially the Nigerian Institute of Medical Research, to join forces with local and international agencies to produce a vaccine for malaria and drugs for some of the neglected tropical diseases. Some of the NTDs include river blindness, trachoma, bilharzia, yaws, elephantiasis, soil transmission helminthiasis, leishmaniasis, leprosy, human African trypanosomiasis, mycetoma and fascioliasis.
Like other vaccines for diseases, storage capacity is crucial in the malaria vaccine delivery, which is currently said to require between 2°C and 8°C due to the sensitivity of liquid AS01 to higher temperatures. Nigeria needs to be prepared and earmark sizable funds to buy, store and administer the vaccine. It should not delay by waiting on donors before tackling the scourge of malaria in the country like it consistently went cap in hand to get COVID-19 vaccine to inoculate a minute number of the population.
Efforts must be made to block areas in the vaccine supply and administration chain, which criminal-minded and greedy Nigerians often exploit for selfish ends. In the past, many of the donated insecticide-treated mosquito nets were diverted by corrupt public officials for sale.
Nigeria can eliminate malaria by 2030 as part of the UN Sustainable Development Goals. But it hesitates at every opportunity to reduce malaria transmission and stamp out the febrile illness. It frittered away the chance to reduce the malaria burden by at least 50 per cent evidence-based interventions through the 1998 Roll Back Malaria project. It is the same situation with the 2005 Abuja Declaration guaranteed to ramp up malaria control interventions.
Health authorities both at the state and federal levels should, beyond taking advantage of the vaccine, generate cogent initiatives for malaria control through integrated vector management, enhanced diagnostics for efficient control and fresh research tools to protect babies and pregnant women, who are special segments of the population. States cannot afford to sit on the fence in the fight against malaria. They should take the lead by ensuring cleaner environments, reducing poverty, motivating health workers, and replacing moribund health centres with well-equipped facilities.
The journey ahead is indisputably gruelling based on the age-long disruptions caused by malaria in many African countries. Thus, Nigeria should exhibit potent willpower to battle the scourge. This stance was reinforced by the WHO Regional Director for Africa, Matshidiso Moeti, when she said that for centuries, malaria stalked sub-Saharan Africa, causing immense personal suffering. She stressed that the vaccine approval offered a glimmer of hope for the continent which shoulders the heaviest burden of the disease, adding that the agency expected many African children to be protected from malaria and grow into healthy adults
Originally published at PUNCH.