RTS,S Vaccine Integration in Cameroon's Immunization UPSC

RTS, S MALARIA VACCINE

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Context: Cameroon has become the first country in the world to include the RTS,S malaria vaccine in its routine national immunization services. This follows a successful pilot program in Ghana, Kenya, and Malawi, demonstrating efforts to expand vaccination against malaria in high-risk areas.

Key Highlights

Malaria is a significant cause of death, especially among children under five, worldwide. Over 30 countries have regions with moderate to high malaria transmission. The disease is transmitted through the bite of infected mosquitoes and is both preventable and curable.
Africa bears the highest burden of malaria, accounting for a substantial percentage of cases and deaths globally. In 2022, India contributed significantly to the malaria cases in the WHO Southeast Asia Region, emphasizing the global nature of the disease.
The malaria vaccine rollout is part of a UNICEF initiative, and the contract for vaccine supply was awarded to GSK, a British multinational pharmaceutical and biotechnology company.
The World Health Organization (WHO) recommends a schedule of four doses of the RTS,S/AS01 vaccine starting from around five months of age. An additional fifth dose may be considered in areas where there is still a significant malaria risk in children one year after receiving the fourth dose.
While the efficacy of the RTS,S/AS01 vaccine is considered modest, it still provides significant public health benefits. The vaccine is designed to work alongside other recommended malaria control interventions, including the use of insecticide-treated bed nets, indoor spraying of insecticides, and prompt diagnosis and treatment.
The expected rollout of a second malaria vaccine, R21, developed by Oxford University. This vaccine, if approved, is anticipated to significantly increase the number of available doses and will be manufactured by the Serum Institute of India.

RTS,S Malaria Vaccine

●The RTS,S vaccine specifically targets the Plasmodium falciparum parasite, responsible for the most severe and deadly form of malaria globally. It works by stimulating the immune system to produce antibodies that block the parasite's ability to invade red blood cells, the primary site of its replication.

●Initial large-scale trials were conducted in Ghana, Kenya, and Malawi, demonstrating a significant reduction in malaria cases, particularly severe malaria in children.

●In October 2021, the World Health Organization (WHO) recommended the RTS,S vaccine for use in children living in areas with moderate to high malaria transmission.

●In January 2024, Cameroon became the first country to officially introduce the RTS,S vaccine into its routine immunization program for children.

●With GAVI, the Vaccine Alliance, supporting the procurement and delivery of the vaccine, 20 countries are aiming to implement pilot programs in 2024, with wider rollout planned for the coming years.

●While the RTS,S vaccine doesn't offer complete protection against malaria, it provides a 30% reduction in severe malaria and a 21% reduction in hospitalization due to malaria in children.

●The RTS,S vaccine is currently recommended for children around 5 months of age, administered in a schedule of 4 doses. In areas with high malaria transmission, a 5th dose may be considered one year after the 4th dose.

Conclusion

The RTS,S malaria vaccine marks a significant milestone in the fight against this devastating disease. While challenges remain in scaling up access and ensuring long-term impact, this innovative tool holds immense promise for saving lives and reducing the burden of malaria, particularly among children in vulnerable regions. Continued research and development, coupled with global collaboration and commitment, are crucial to achieving a malaria-free future.

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PRACTICE QUESTION

Q. Climate change is expected to influence mosquito breeding patterns and malaria transmission dynamics. How will rising temperatures, precipitation changes, and other environmental factors reshape the future of malaria epidemiology, and what innovative approaches can be implemented to mitigate these impacts?