Developments and their Applications and Effects in Everyday Life

General Studies Paper 3

Context

• A malaria vaccine —R21/MatrixM —developed by the University of Oxford, manufactured by the Pune based Serum Institute of India (SII) and tested in a phase 3 trial at five sites in Africa, was recommended by the WHO on October 2.
• Three countries — Nigeria, Ghana, and Burkina Faso — have already approved the use of the vaccine to immunise children aged less than 36 months.

The threat of Malaria:

• Malaria is a mosquito-borne infectious disease that affects humans and other vertebrates. Symptoms usually begin 10 to 15 days after being bitten by an infected Anopheles mosquito.
• Human malaria causes symptoms that typically include fever, fatigue, vomiting, and headaches. In severe cases, it can cause jaundice, seizures, coma, or death.
• While Plasmodium falciparum is responsible for more deaths, Plasmodium vivax is the most widespread of all of the malaria species.
• Malaria is most common in tropical and subtropical regions of the world, including sub-Saharan Africa, Southeast Asia, and South America. According to the WHO, in 2021, there were 247 million malaria cases worldwide and 6,19,000 deaths. About 25 million children are born each year in countries with moderate to high malaria transmission.
• India has been able to reduce the prevalence of the disease by 66% between 2018 and 2022.

Efficacy of malaria vaccines:

• The first malaria vaccine was RTS,S/AS01, recommended by the World Health Organisation (WHO) in 2021 to be rolled out in high transmission African countries, understanding the urgency of malaria control and prevention.
• RTS,S/AS01 was developed by GlaxoSmithKline (GSK), Bill and Melinda Gates Foundation etc. In India, Bharat Biotech has been granted license to manufacture this vaccine. All trials of this vaccine shows efficacy below 60%. Till now, no malaria vaccine has shown the benchmark efficacy of 75% set by WHO.
• The efficacy of R21/ MatrixM is much higher than RTS,S/AS01/ The results indicate that the new vaccine was more efficacious in places where malaria was seasonal than when it was perennial. The authors think that this may partly be due to timing of malaria episodes in countries with seasonal or perennial malaria.
• Since the vaccination is carried out just before the beginning of the malaria season, the protection offered is higher when the disease is seasonal than when malaria occurs throughout the year. The vaccine may help reduce malaria transmission, especially when combined with other strategies such as mosquito nets.
• According to WHO, the cost of the R21/MatrixM manufactured by Serum Institute will be between $2 and $4 per dose. Serum Institute will produce “over 100 million doses a year”. So it will be affordable and accessible to those who need it.

Global initiatives on malaria:

• Global Malaria Program: launched by WHO and guided by the “Global technical strategy for malaria 2016–2030”. The strategy aims to reduce malaria case incidence and mortality rates by at least 75% by 2025 and 90% by 2030, from 2015 level .
• Malaria Elimination Initiative: launched by Bill and Melinda Gates Foundation
• E-2025 initiative: In 2021, WHO launched it to halt the transmission of malaria in 25 identified countries by 2025.

Indian initiatives on malaria:

• National Vector-Borne Disease Control Programme: It is an umbrella programme for prevention and control of vector borne diseases including Malaria, Dengue, Chikungunya etc.
• National Malaria Control Programme (NMCP): undertakes measures like insecticidal residual spray (IRS) or DDT, monitoring and surveillance of cases, treatment of patients etc.
• National Framework for Malaria Elimination 2016-2030: Based on WHO Global Technical Strategy for Malaria 2016–2030 (GTS), it aims to eliminate malaria (zero indigenous cases) in India by 2030, maintain malaria–free status in areas where malaria transmission has been interrupted and prevent re-introduction of malaria.
• Malaria Elimination Research Alliance-India (MERA-India): an ICMR-led research collaboration on malaria control.

Conclusion

• The development and approval of new malaria vaccines will aid in India’s aim to be malaria-free by 2027 and to eliminate the disease by 2030.