More funding needed for rollout of highly effective malaria vaccine, Oxford chief warns

‘It seems extraordinary after the worst pandemic we’ve had in a century ... we can’t find the money to get Africa out of the horrendous mortality that it’s been suffering from malaria,’ says Professor Adrian Hill

Samuel Lovett
Science Correspondent
Friday 22 April 2022 10:39 BST
The vaccine was due to be rolled out in African countries where malaria is a leading cause of death in young children and infants
The vaccine was due to be rolled out in African countries where malaria is a leading cause of death in young children and infants (AP)

More government funding is needed to faciliate the rollout of the world’s most effective malaria vaccine in Africa, the Oxford professor who developed the jab has warned.

It was announced in April 2021 that the vaccine was 77 per cent effective in protecting against the mosquito-borne disease - the first time that a malaria jab has surpassed the 75 per cent efficacy goal set by the World Health Organisation.

After more than a century of trying, the development of a highly protective vaccine was lauded as a major scientific breakthrough for humanity - but Professor Adrian Hill, who designed the jab at Oxford University’s Jenner institute, said it was unlikely that a mass rollout would begin until next year.

Prof Hill called on the UK government to increase its funding for tackling malaria in Africa, arguing that the world now has the resources and technology it needs to eradicate the disease by the end of the next decade.

“Money will be required to fund the provision of doses and a new immunisation campaign for the malaria vaccine,” Prof Hill told reporters during a media briefing on Thursday.

“It seems extraordinary after the worst pandemic we’ve had in a century, where vaccines have played a very major role in getting us out of the pandemic, that we can’t find the money to get Africa out of the horrendous mortality that it’s been suffering for decades and decades, if not hundreds of years, from malaria.”

Oxford’s malaria vaccine is still being trialled among thousands of infants in Western and Eastern Africa. This will confirm the safety of the vaccine, though Prof Hill told The Independent last year that “it’s hard to imagine that efficacy would be hugely different” from what has already been seen.

Speaking on Thursday, Prof Hill said the world has “gone backwards in the last couple of years” as a result of disruption from Covid-19.

There were an estimated 241 million cases and 627,000 malaria deaths worldwide in 2020, according to the World Health Organisation.

This represents about 14 million more cases in 2020 compared to 2019, and 69, 000 more deaths. Approximately two-thirds of these additional deaths were linked to disruptions in the provision of malaria prevention, diagnosis and treatment during the pandemic, the WHO said.

The Global Fund estimates that to reverse these trends, worldwide funding for malaria - alongside HIV and tuberculous - will need to increase by 30 per cent, to £13.8 billion, for the next three years.

To help sustain this increase, the British government needs to raise its own contributions to the Global Fund from £1.46 billion, which covered 2020 to 2022, to £1.8 billion, according to Malaria No More UK.

Prof Hill said it would be possible to “knock down [malaria] deaths” within the next decade by “maybe 75 per cent, maybe even 90 per cent,” if all relevant tools can be deployed effectively in Africa. This means making the Oxford vaccine widely available to those who need it, he added.

Once deaths are reduced “substantially,” it could be possible to eradicate malaria by 2040, Prof Hill said.

“As with polio, once you do that, you get your money back, you stop spending billions a year on controlling malaria if you can eliminate it,” he added.

“It’s a choice for society, for governments. Are we serious about this? We know that far more people died from malaria than from Covid in 2020 in Africa, very likely in 2021 as well. This is a value judgement. Are we going to provide this money to to control a disease that is now controllable because new tools are becoming available?”

Scientists have been trying to produce an effective vaccine against malaria, caused by the Plasmodium parasite, since 1907.

Due to the size of the malaria parasite, which is much bigger than a virus, finding the right protein in its genome to target and neutralise is remarkably difficult, making both natural and artificially induced immunity hard to achieve.

GlaxoSmithKline’s vaccine has already been recommended for use in sub-Saharan Africa by the WHO. The findings of a pilot programme run in Ghana, Kenya and Malawi showed the vaccine led to a 30 per cent reduction in severe malaria among young children. Separate research from the London School of Hygiene and Tropical Medicine has shown the jab can be up to 70 per cent efficacious as part of a seasonal prevention approach.

To date, more than 1 million children have now received one or more doses of the GSK vaccine.

Prof Hill said it was unlikely the Oxford malaria vaccine would be rolled out on a mass scale until next year. The quicker more funding arrives, the quicker the immunisation programme can start, he said.

“What strikes me as somebody who’s worked on malaria for a very long time, is that when Covid appeared, money appeared out of the system,” Prof Hill said.

“It’s only when it really hits home to countries around the world, all around. that money is extracted from the system.

“Now that we have the technologies obviously developed in Africa … why waste all that investment of time and delay another five to 10 years till we feel comfortable about our personal budgets again.

“I think the money is in the system. We’re not talking about tens or hundreds of billions of dollars which were required for the Covid response. We’re talking about hundreds of millions. It’s money that that is there.”

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