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In addition, a Participating States Initiated Activity (PSIA) funded by the UK has demonstrated the value of combining RTS,S/AS01 with seasonal malaria chemoprevention – pre-emptive use of antimalarial drug treatments in areas where transmission occurs only during particular months of the year.
A trial involving nearly 6,000 children in Burkina Faso and Mali showed that, after 5 years, the combination of the two interventions substantially reduced hospitalisations and deaths due to malaria compared with seasonal malaria chemoprevention alone. Among those receiving both interventions, deaths from malaria were 66.8% lower than in the group receiving seasonal malaria chemoprevention alone.
The findings, published in The Lancet in 2023, suggest the two interventions may be acting synergistically, delivering benefits greater than would be expected on the basis of their individual effects.
Malaria kills around half a million young children in Africa every year. After decades of endeavour, effective vaccines are now being introduced which, alongside other preventive measures such as insecticide-impregnated bed nets, will help to reduce this toll.
In 2023, WHO recommended use of the R21/Matrix-M malaria vaccine, supported by EDCTP through phase I and phase II trials. R21/Matrix-M shows good efficacy and has the potential to be manufactured in large volumes, helping to meet strong country demand for malaria vaccines. It has already been approved by several countries in Africa and is due to be introduced during 2024.
R21/Matrix-M is following the path forged by the first effective malaria vaccine, RTS,S/AS01. EDCTP also provided support during the development of this vaccine, for example for studies embedded in the Malaria Vaccine Implementation Project in Ghana, Malawi and Kenya, which examined the benefits of a fourth dose of RTS,S/AS01 and potential safety issues. Additional EDCTP-funded studies in Ghana focused on optimising vaccine implementation and in Kenya on impacts of vaccination on brain conditions linked to malaria infections.
Children in Africa now have access to two malaria vaccines, both of which have received support from EDCTP during their development.
Malaria vaccines come of age