The World Health Organisation (WHO) recently approved the first malaria vaccine, Mosquirix of RTS, for paediatric use. The four-shot vaccine, to be administered on the thigh or deltoid muscle of the shoulder, is for paediatric use and targets one of the many malaria parasites, Plasmodium falciparum. The vaccine, produced and developed by GlaxoSmithKline, has been used across several countries in sub Saharan Africa, with a 30 per cent efficacy reported. The WHO approval came after surveying the results of a test study in Ghana, Kenya and Malawi, under which 2.3 million children were administered the vaccine since 2019.
The WHO feels that this vaccine, despite the limitations of a 30 per cent efficacy, and a short-lasting effect on the recipient, could help in tackling malaria in the continent which accounts for around 95 per cent of the disease caseload in the world.
India, too, is endemic for malaria, but this vaccine can have only a limited impact here, and therefore, sources say that it might not get into the national vaccination programme anytime soon. Experts however, do recommend that the country should purchase consignments of the vaccine for administering in high-burden states, given India's goal of eliminating malaria by 2030, which is nine years away.
India launched the National Framework for Malaria Elimination in 2016. The country, however, has witnessed a continuous and sustained falling in the number of cases, mortality and morbidity since 2000, according to WHO's World Malaria Report, 2020. The cases and fatalities have declined significantly by 21.27 per cent and 20 per cent in 2019 (3,38,494 cases, 77 deaths) as compared to 2018 (4,29,928 cases, 96 deaths). Even making adjustments for massive under reporting, it is clear that malaria cases are on the decline, and proper treatment has reduced deaths significantly. Also, though the disease is notifiable across 31 states and union territories, only around 11 of them are considered as high burden states, of which Odisha has the highest number.
In India, traditionally, Plasmodium vivax was the predominant malaria causing agent. Over the years, P falciparum is gaining ground, and in some states like Odisha, there is almost a 50:50 ratio between the two types. The Mosquirix vaccine, however, only acts on falciparum. This, it is of limited benefit in India. In India, usually vaccines have to show at least a 65 per cent efficacy to get included into the vaccination programme.
Bharat Biotech, the Indian partner in manufacturing, has not yet unveiled its plans for the Indian market.