Malaria is a killer and the mosquito which carries it is probably the deadliest animal in human history.
Malaria is one of the most severe public health problems worldwide. It is a leading cause of death and disease in many developing countries, where young children and pregnant women are the groups most affected. According to the 2021 World Malaria Report:
- Nearly half the world’s population lives in areas at risk of malaria transmission in 87 countries and territories.
- In 2020, malaria caused an estimated 241 million clinical episodes, and 627,000 deaths. An estimated 95% of deaths in 2020 were in the WHO African Region.
WHO has now approved R21, a vaccine developed by the University of Oxford. This is the second vaccine approved by the WHO, two years after GSK’s version designated RTS,S/AS01. Since then about 81 million doses have been available. The big difference is in cost and scale.
The WHO said the new R21 vaccine would be a "vital additional tool". Each dose costs $2-4 (£1.65 to £3.30) and four doses are needed per person. That is about half the price of RTS,S.
The two vaccines use similar technologies and target the same stage of the malaria parasite's lifecycle. However, the newer vaccine is easier to manufacture as it requires a smaller dose and uses a simpler adjuvant (a chemical given in the vaccine that jolts the immune system into action).
In 2021, there were 247 million cases of malaria and 619,000 people died, most of them children under the age of five. More than 95% of malaria is found in Africa.
The Serum Institute of India helped develop and is to manufacture more than 100 million doses a year increasing to 200 million p.a. They are the largest vaccine manufacturer and produced a large majority of the “Oxford/AstraZenica” COVID vaccine. This adenovirus vector vaccine was the first available and was designed to not need the more extreme cold storage required by the mRNA vaccines and thus was more suitable for delivery in countries where these facilities were difficult to maintain along the whole supply chain.
As a result of this commitment to ensuring global and equitable access, the Oxford-AstraZeneca vaccine saved 6.3 million lives in the first year of the global vaccine rollout – the most out of all the vaccines in circulation at the time.
Airfinity, which conducted this analysis, further said that the vaccine may have saved the most lives before it first went to older age groups in high income countries and nations with less robust health care systems.
An expert review of data from 79 real-world studies lends further credence to the wide-ranging impact of the Oxford-AstraZeneca vaccine, revealing that it provided equally effective and high protection against hospitalisation and death as mRNA COVID-19 vaccines.
To make their vaccine more accessible, Oxford University required its producers to sell “at cost” during the period of the pandemic. I could not find data about this aspect of the malaria vaccine but that it is half the cost of the rival vaccine is significant.