Science
Mint Primer: Malaria gets its second vax: Why it’s momentous
Summary
The R21/Matrix-M, developed by Oxford University and Serum Institute of India, has shown up to 75% efficacy
A malaria vaccine developed by Oxford University and Serum Institute of India (SII) has been recommended for large-scale use by the World Health Organization (WHO). The R21/Matrix-M—only the second malaria jab—has shown up to 75% efficacy. Mint explains:
What are the features of the vaccine?
The vaccine was developed using US firm Novavax’s adjuvant technology. An adjuvant is a substance added to a jab to boost its immune response. The vaccine is shown to be effective in a wide range of settings, from places with high seasonal malaria to ones with perennial transmission. While efficacy from three doses waned after a year, a booster shot restored it. Cost is another factor in its favour. The $2-4 price tag per dose is comparable to other childhood jabs, enabling quicker scale-up at country-levels. The Phase III trials included 4,800 children aged 3-5 years from Burkina Faso, Kenya, Mali and Tanzania.
Why did it take so long for a vaccine?
A key reason for the delay is the stumbling blocks in vaccine development for ‘neglected’ diseases such as malaria, even tuberculosis and HIV-AIDS, which largely affect developing and under-developed countries. For some diseases, the return on investment is lower for vaccine manufacturers, which also translates into large funding shortfalls. Malaria, for instance, has a $3.8-billion funding gap globally, each year, according to RBM Partnership, a Switzerland-based non-profit. The complex genetic make-up of the parasite that causes malaria has also made the technology difficult to crack.
What is the existing vaccine against malaria?
It was developed by GSK, a UK drugmaker, and got approval in 2021. However, only 18 million doses are available, to be allocated across 12 African countries over 2023-2025. With demand far outstripping the supply, the new vaccine’s scalability makes it an important development to “protect more children faster", the WHO says.
What is the potential impact of the new jab?
Malaria had 247 million cases globally in 2021, with 619,000 deaths. Nearly half a million children, mainly in Africa, die of it each year. It’s prevalent in India despite massive strides—cases fell from 338,494 in 2019 to 176,522 in 2022, according to the National Vector Borne Disease Control Programme. With SII announcing a capacity of producing over 100 million doses a year (and soon 200 million), the vaccine, along with other public health measures, could aid India’s goal to eliminate malaria by 2030.
When will it come to India?
The vaccine is expected to be available globally in mid-2024. However, there’s no clarity on its availability in India yet. Indian rules ask for clinical trials to be conducted within the country. Broadly, the next immediate steps include completing the WHO prequalification process that assesses the quality, safety and efficacy of medicinal products, which would enable international procurement for a wider rollout. The Oxford-SII partnership is not new, having yielded successful results with Covishield.
