As the World Health Organisation announces the next step in its rollout of the world’s first authorised malaria vaccine in three African countries, concerns about its value have come from an unlikely source: the Bill and Melinda Gates Foundation, arguably the vaccine’s biggest backer.
AdvertisementWHO endorsed the vaccine last fall as a “ historic ” breakthrough in the fight against malaria, but the Gates Foundation told The Associated Press this week it will no longer offer direct financial support to the shot although it will fund an alliance backing the vaccine. Some scientists say they’re mystified by that decision, warning it could leave millions of African children at risk of dying from malaria as well as undermine future efforts to solve intractable problems in public health. The vaccine, sold by GlaxoSmithKline as Mosquirix, is about 30 per cent effective and requires four doses.
The malaria vaccine has “a much lower efficacy than we would like,” Philip Welkhoff, the Gates Foundation’s director of malaria programs, told the AP. Explaining its decision to end support after spending more than USD 200 million and several decades getting the vaccine to market, he said the shot is relatively expensive and logistically challenging to deliver. “If we’re trying to save as many lives with our existing funding, that cost-effectiveness matters,” he said. The Gates Foundation will continue its financial support to Gavi, a vaccines alliance that is also backed by WHO and the World Bank. “We’re supporting the roll-out via the Gavi funding, but we decided we would not dedicate additional direct funding to extend the supply of the vaccine,” Welkhoff said. The Gates Foundation’s decision to pivot away from supporting the rollout of the vaccine in Africa was made years ago after detailed deliberations, including whether the foundation’s money would be better spent on other malaria vaccines, treatments or production capacity, Welkhoff said. Some of the resources that might have gone into getting the vaccine to countries have been redirected to buy new insecticidal nets, for example.
Millions of older people don’t get enough nutrients – how to spot it and what to do about it
“I’m not Malala, I’m free & safe in India”: Kashmiri activist denounces Pakistan’s propaganda mechanism at UK parliament
AdvertisementOn Thursday, WHO and Gavi invited developing countries to apply for funding to pay for the malaria vaccine in their countries. ”If delivered to scale, the vaccine will help to prevent millions of cases of malaria, save tens of thousands of lives and ensure a brighter future for the continent,” said Dr. Matshidiso Moeti, WHO’s Africa director. The Gates Foundation’s withdrawal of financial support for the malaria vaccine might unnerve others, Dr. David Schellenberg of the London School of Hygiene and Tropical Medicine, said. “There is a risk that this could discourage others who are considering financing the malaria vaccine or even be a disincentive for people working on other vaccines,” he said. He said that combining the vaccine’s use with other measures, like distributing drugs during malaria’s peak season could dramatically reduce cases and deaths. “We still see people coming in with four or five episodes of malaria a year,” he said. “We don’t have a magic bullet, but we could make better use of the tools we do have.” An imperfect roll-out of the vaccine would still save lives, Dr. Dyann Wirth, an infectious diseases expert at Harvard University, said. “We would love to have 100 million doses, but that kind of money doesn’t exist for malaria,” she said. “The 15 million doses we have is still 15 million opportunities to protect children that we didn’t previously have.” The Gates Foundation had done its part in bringing the vaccine to market and it is now up to countries, donors and other health organizations to ensure it is used, she said. The vaccine, even with its imperfections, is eagerly awaited in Malawi. Nolia Zidana, 32, said she is keen to get her two young sons immunized after seeing malaria sicken them numerous times — and surviving it herself. “Growing up with my parents and siblings, we have been sick from malaria all the time,” said Zidana, who lives in Malawi’s central Ntcheu district. “My elder son has had malaria countless times within the four years that he has been around. While just at 7 months old, twice my younger son has already been down with malaria,” she said. She said although they sleep under mosquito nets, sometimes they get bitten before going to bed as they are preparing meals for supper in the dark of the evening. “We hear other people use mosquito repellents or burn anti-mosquito incense coils, which we cannot afford as we are just peasant farmers that live from hand to mouth,” she said. Dr. Michael Kayange of Malawi’s Ministry of Health, urged everyone in the country to take whatever measures they can to curb malaria. Immunization itself is insufficient to stop the disease and people should adopt multiple strategies, he said. “Even just by sleeping under a mosquito net, you have played your role in reducing the malaria burden in the country,” he said.