LETTER TO THE EDITOR Year : 2022  |  Volume : 59  |  Issue : 4  |  Page : 386-387

Vaccine against malaria: A ground-breaking step towards elimination in India

Sadhvika Kanagat, Abhijit Vinodrao Boratne
Department of Community Medicine, Mahatma Gandhi Medical College and Research Institute, Puducherry, India

Date of Submission04-Nov-2001Date of Acceptance11-Aug-2022Date of Web Publication07-Feb-2023

Correspondence Address:
Dr. Sadhvika Kanagat
Department of Community Medicine, Mahatma Gandhi Medical College and Research Institute, Puducherry 607402
India

Source of Support: None, Conflict of Interest: None

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DOI: 10.4103/0972-9062.355961

How to cite this article:
Kanagat S, Boratne AV. Vaccine against malaria: A ground-breaking step towards elimination in India. J Vector Borne Dis 2022;59:386-7
How to cite this URL:
Kanagat S, Boratne AV. Vaccine against malaria: A ground-breaking step towards elimination in India. J Vector Borne Dis [serial online] 2022 [cited 2023 Feb 9];59:386-7. Available from: http://www.jvbd.org//text.asp?2022/59/4/386/355961
Malaria can kill a person within 24 hours of disease onset and Plasmodiumfalciparum is the deadliest malarial parasite in the world. In 2019, 229 million cases of malaria occurred around the world with 94% contribution from African countries. India carries 2% of the global malarial burden and 85.2% of the burden in south east Asia. Until July 2021, a total of 64,520 cases and 35 deaths of malaria were reported in India of which 44,391 cases were due to P. falciparum[4]. October 6, 2021 marks a historic day against malaria for the world as the first ever malaria vaccine for children was launched[1]. The RTS, S/AS01 vaccine known by the brand name of Mosquitrix was introduced after more than 30 years of hard work and research. This was developed by pharma major GlaxoSmithKline (GSK) in partnership with PATH which is an international nonprofit organization that collaborates with countries and institutions on health problems. This vaccine has been a breakthrough in the area of child health and malaria control.

The World Health Organization (WHO) recommends the use of this vaccine in the prevention of P. falciparum malaria in children living in the areas with moderate to high disease transmission. It is to be given in a schedule of four doses from the age of five months. The vaccine has been brought to market following a pilot study which was done for two years in child health clinics of three countries including Ghana, Kenya and Malawi. The key findings derived from the pilot study include feasibility of the vaccine, the reach of the vaccine to various children without affecting other childhood vaccinations, safety profile and cost effectiveness. Also, it did not have any negative impact on other preventive measures and the health seeking behaviors for febrile illnesses of the community[2]. A modelling study done in sub-Saharan Africa to estimate the impact of RTS, S/AS01 vaccine allocation strategies showed that this vaccine could prevent 23,000 deaths in children every year in Africa and recommendations for the vaccine to be introduced at the sub national level and high incidence countries were made[3]. According to WHO 2019 report, more than half of the malarial deaths around the globe are in six sub-Saharan African countries and Nigeria. However, India cannot be underestimated as the malarial figures reported in India are just the tip of the iceberg. WHO malarial figures rely mainly on the health reporting data and almost 80% of the malarial cases in India are from visits in informal health care setups where the reporting is not up to the mark. Various difficulties in diagnostics, documentation, laboratory evidence and reporting by the private and informal sectors leads to underreporting of malaria cases. In India, until 2017 only 8% of the malarial cases were reported. As per (National Vector Borne Disease Control Program (NVBDCP) data, the annual parasite incidence (API) in most of India was less than 2, 2–5 in some regions and more than 5 in scattered places in Rajasthan, Gujarat, Karnataka, Goa, Madhya Pradesh, Chhattisgarh, Jharkhand, Orissa and northeastern states.

On the brighter side, India is the only endemic country in the south east Asian region which has contributed to the largest drop in cases i.e., six million from approximately 20 million. This does not give us the privilege to avoid taking steps in completely eliminating this disease. As malaria is an illness which is influenced by various factors, it can flare up at any point of time leading to large outbreaks. The measures such as insecticide sprayed nets have been a constant source of environmental pollution and they are mixed with asbestos, making it very difficult to dispose them properly[5]. However, it has been agreed upon that pan India roll out is not necessary, and only high disease burden states such as Jharkhand, Chhattisgarh, Orissa, Madhya Pradesh, Meghalaya would need the vaccine immediately[6]. As much as the African countries would be benefitted from this vaccine in saving millions of lives, in India, this vaccine combined with the other preventive measures would aid in giving the final push for elimination of malaria for good.

Ethical statement: Not applicable

Conflict of interest: None

 

  References 
1.WHO recommends groundbreaking malaria vaccine for children at risk. Available from: https://www.who.int/news/item/06-10-2021-who-recommends-groundbreaking-malaria-vaccine-for-children-at-risk (Accessed on January 01, 2021).  
    2.The RTS, S Malaria Vaccine. Available from: https://www.who.int/multi-media/details/the-rts-s-malaria-vaccinev2 (Accessed on January 01, 2021).  
    3.Hogan AB, Winskill P, Ghani AC. Estimated impact of RTS, S/AS01 malaria vaccine allocation strategies in sub-Saharan Africa: A modelling study. PLoS Med 2020; 17(11): e1003377.  
    4.Malaria. Available from: https://www.who.int/westernpacific/health-topics/malaria (Accessed on January 01, 2021).  
    5.Malaria vaccine: India needs it too, say experts [Internet]. [cited 2021 Oct 28]. Available from: https://www.downtoearth.org.in/news/health/malaria-vaccine-india-needs-it-too-sayexperts-79597 (Accessed on January 01,2021).  
    6.Kumari R. World Health Organization Country Office for India, New Delhi, India. High Burden to High Impact (HBHI) Approaches - Country Perspective for Adoption and Adaptation in India. J Commun Dis 2020 Sep 30; 52(03): 5–16.