Gavi opens country applications to roll out new malaria vaccine

Gavi, the Vaccine Alliance, has opened up applications to Ghana, Kenya, and Malawi for funding to roll out the world’s first malaria vaccine, RTS,S, on a national scale. The three countries were chosen because they’ve already piloted the administration of the vaccine on a smaller scale in their countries since 2019.

Gavi’s board approved $155.7 million in December for these efforts, which aim at supporting rollouts through 2025.

While current demand exceeds supply of the vaccine, Gavi ultimately plans to expand its applications to other eligible countries, which encompasses over 25 million children.

Last October, the World Health Organization recommended use of the vaccine, which had been under development for decades.

The pilot programs in the three countries have targeted 1.3 million children.

“Where the vaccine has been introduced, there has been a substantial drop in children being hospitalized with severe malaria and a drop in child deaths in the age group that is eligible for the vaccine,” WHO wrote in a press release. The demand for the vaccine in the pilots has been high.

An estimated 260,000 children on the African continent under the age of 5 die annually from malaria.

The three countries are expected to submit applications by Sept. 13. A second window, which opens at the end of the year and closes in January, will be open to countries beyond the initial three. 

These other countries, while not eligible for the first round of funding, can still submit expressions of interest, which will allow Gavi to provide them with support so that they can submit strong applications, said the organization in a press release. The countries that have piloted the administration of the vaccine won’t need these same levels of support, according to a spokesperson.

To ease supply constraints, manufacturing needs to ramp up, and there is also a need for more investment in technology transfer, said Thabani Maphosa, the managing director of country programs at Gavi. The estimated demand is about 80 to 100 million doses annually.

When supply does meet demand, this vaccine could save tens of thousands of lives each year, said professor Rose Leke, a malaria disease expert from the University of Yaounde in Cameroon and co-chair of the expert group that advised WHO on a framework to distribute the supply of these vaccines.

The vaccine only has a modest efficacy — a 30% reduction in deadly, severe malaria. Because of this, the development of other vaccines, hopefully more efficacious, is ongoing. But in the meantime, given the urgency of the problem, this is the best vaccine available, so it needs to be rolled out at scale, Maphosa said.