Health
Two years after the World Health Organisation, WHO, announced the release of the first-ever malaria vaccine on October 6, 2021, Nigerians are yet to benefit from the release of the vaccine and mitigate the effects of the killer parasite as the country has continued to groan under the huge burden of losses caused by malaria.
By Anthony Isibor
JUST recently, Dr Mohammed Abdulkadir, a Consultant Paediatrician at the University of Ilorin Teaching Hospital, decried the prevalence of malaria in Nigeria in spite of the efforts by the government to check the spread in the country.
Abdulkadir, who was speaking in commemoration of the 2023 World Malaria Day in Ilorin, acknowledged that although these efforts have led to a reduction in the prevalence of malaria parasite in children under the age of five reduced from 42 per cent in 2010 to 23 per cent in 2018, he, however, regretted that Nigeria still accounts for 26.6 per cent of malaria cases in the world and 31.3 per cent of deaths caused by malaria across the world.
However, Prof Mojisola Adeyeye, Director General, National Agency for Food and Drug Administration and Control, NAFDAC, while announcing the approval of the R21/Matrix-M malaria vaccine, noted that the parasite has remained the most important public health concerns in the world.
According to her, malaria is transmitted throughout Nigeria with 97 per cent of the population at risk. The duration of the transmission season ranges from year-round transmission in the south to three months or less in the north.
The latest WHO Malaria Report shows that there were 247 million cases of malaria in 2021 compared to 245 million cases in 2020.
She explained that the estimated number of malaria deaths stood at 619000 in 2021 compared to 625000 in 2020.
“Over the two peak years of the pandemic (2020–2021), COVID-related disruptions led to about 13 million more malaria cases and 63000 more malaria deaths.
“The WHO African Region continues to carry a disproportionately high share of the global malaria burden. In 2021 the region was home to about 95 per cent of all malaria cases and 96 per cent of deaths.
“Children under five years of age accounted for about 80 per cent of all malaria deaths in the region. Four African countries accounted for just over half of all malaria deaths worldwide, with Nigeria; 31.3 per cent, the Democratic Republic of the Congo; 12.6 per cent, United Republic of Tanzania; 4.1 per cent and Niger; 3.9 per cent respectively,” she added.
It was therefore a relive for all when on Wednesday, April 26, 2023 during Sunrise Daily, Prof. Adeyeye announced that clinical trials for the R21/Matrix-M malaria vaccine would begin in six weeks.
Although Gavi, the Vaccine Alliance, has noted that with an estimated 40-60 million doses currently to be needed by 2026 alone, growing to 80-100 million doses of vaccines needed each year by 2030, supply must grow significantly to meet demand.
Adeyeye, however, noted that the provision of the vaccine is important for transmission prevention and that NAFDAC is going to do its own test, trials and levels of approval.
“The clinical trial will begin within the next six weeks. The RTS did not include Nigeria, because from the beginning the effectiveness was 30 percent, so we did not agree to join the clinical trial,” the NAFDAC boss said.
“For the R21, after reading the dossier, I believe Nigeria should join. This is because we have a high probability of success. If something is 75 percent effective from the beginning, then we know there are very likely to be successful. It has 75 percent effectiveness for a malaria vaccine, which is great.”
Adeyeye said that phase four clinical trials would be conducted with more laboratory work.
“However, it is not what is written only that we know as the efficacy; we have to check every line of the dossier to ensure that science speaks. This is science-driven. What we did was to have two sets of review,” she said.
According to her, for the first time in the agency’s history, NAFDAC is going to have an external expert body for phase four.
“We are going to do phase four clinical trials; it should be tested in our country. We are going to do more observation. This would involve more laboratory works, this cannot be administered until it goes through a testing process in the country before the transmission process,” Adeyeye said.
The NAFDAC boss stated that the vaccination focus is mainly on children and not adults, adding that this is the limitation the RTSS malaria vaccine has in its percentage efficacy.
“Even if it is only 30 percent of the children that will not die or the death would be prevented, that will be good enough. But we didn’t take that up as an agency to be part of the trial. This particular R21 had been submitted to WHO and they are going to be doing their own review,” she said.
“NAFDAC approved the R21 vaccine for children under five, specifically for those under three years. NAFDAC tested the second vaccine (RTSS) and was not found effective enough. Nigeria is part of this one that is R21, we gave provisional approval after a very rigorous approval process,” she said.
Adeyeye stated that NAFDAC as a regulatory body is doing all in its power to think critically and judiciously evaluate the dossier and come to a decision.
“The 75 percent, I believe, is a great point or great efficacy to start with in terms of our own people. But the clinical trial will start very soon.
“I have been talking with the manufacturer, with the market authorisation holder in Nigeria. The clinical trial will begin very soon. The experts have suggested younger colleagues in the universities that will be part and parcel of the clinical trial,” she said.
As a further confirmation of the need to begin the use of the vaccine in Nigeria, Nonye Soludo, wife of the Anambra Sate Governor, explained that the state will be among the first states to take delivery of the new malaria vaccine.
In a statement released by her media aide, Daniel Ezeigwe, the decision was taken because of the government’s concern on possible elimination of the disease in the state through a well-coordinated healthcare service delivery in the state.
She said that taking delivery of the vaccine, which has been consented to for use in the country, would bring to an end the era of one of the commonest household sicknesses in the state.
She explained that since the distribution of over 3.8 million insecticide treated nets in 2022, malaria rate has been significantly reduced in under-five children in the state, from 77.8%, which it stood as at February 2022 to 14.3 % in February 2023.
Soludo appealed to the public, especially those housing children and pregnant women, to continue to sleep under mosquito nets because of its unlimited benefits to achieving a healthy living and a prosperous state.
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Tags: 2023 World Malaria Day Dr Mohammed Abdulkadir GAVI NAFDAC Prof Mojisola Adeyeye
