the vaccine recommended by the WHO between hopes and uncertainties

On Wednesday October 6, the World Health Organization (WHO) caught the world by surprise by announcing a “Historic moment” in the fight against malaria. While this scourge killed 409,000 people in 2019 – including 94% in Africa and 67% of children under five – this is the first time that the WHO has recommended “Large-scale deployment”, a vaccine against malaria, « RTS, S » (marketed by the firm GSK under the name Mosquirix). In 2015, the latter obtained a positive opinion from the European Medicines Agency, the EMA.

The UN organization now advocates the extended use of this vaccine “In children in sub-Saharan Africa and other parts of the world with moderate to high transmission of Plasmodium falciparum », the parasite responsible for this disease, transmitted by mosquito bites.

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” Highly anticipated “, this vaccine represents, according to Dr Tedros Adhanom Ghebreyesus, Director General of the WHO, “A breakthrough for science, children’s health and disease control”. Its first-line use, among other malaria prevention tools, “Could save tens of thousands of young lives every year”, added Dr Tedros. In Africa, “A child dies of malaria every two minutes”, recalled Professor Francine Ntoumi, director of the Congolese Foundation for Medical Research in Brazzaville, in the journal Nature in 2020.

“Decisive step forward”

But why recommend this vaccination now, when the WHO had decided, as a precaution, to assess its feasibility “in real life”? To do this, in 2019, it launched a large-scale vaccination trial in three African countries, Ghana, Malawi and Kenya, a trial which was to end in 2023 and include one million children, by being funded by three international organizations: GAVI (the Vaccine Alliance), the Global Fund to Fight AIDS, Tuberculosis and Malaria, and Unitaid. The WHO, which to date has included 800,000 children, has therefore anticipated the end of this assessment.

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In clinical trials, this vaccine from GSK has been evaluated in 15,000 young children in seven countries in sub-Saharan Africa, with children drawn to receive a four-dose vaccination schedule (at ages 5, 6, 7 and 17 months), or a control vaccine. In 2015, the verdict was published in the journal The Lancet fell: in children vaccinated with Mosquirix, nearly four in ten malaria episodes and three in ten severe malaria episodes were prevented after four years. A result which, at the time, could be considered disappointing. This vaccine, in fact, is far from being a miraculous protection.

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