Q & A with Nanthalile Mugala
Nanthalile Mugala, MD, MMed, Chief of the Africa Region for PATH, discusses the WHO
recommendation for malaria vaccine.
Q: What might the WHO recommendation mean for malaria-endemic countries in Africa?
A: In my country of Zambia, more than 2.5 million cases of malaria and
nearly 8,000 deaths from the disease occurred in 2019. As a pediatrician and a public health champion, I have seen the devastating effects of malaria on children, families, and communities. The WHO’s recommendation for broader use of the malaria vaccine could save tens of thousands of children’s lives every year.
Q: How do you see the vaccine fitting into overall malaria prevention?
A: Malaria control interventions such as insecticide-treated bed nets, indoor residual spraying, and seasonal malaria chemoprevention have driven down the burden of malaria significantly, but progress has stalled in many countries. We need new tools to get us back on track and RTS,S, is poised to help us do that.
Q: Could you tells us more about the vaccine?
A: RTS,S was developed specifically for children in Africa, as they are most at risk of dying from malaria. The vaccine reduces malaria cases in children, including cases of severe, life-threatening malaria. RTS,S provides significant benefit when used in combination with existing prevention measures. In addition, the vaccine has been shown to provide protection to children who may not have access to other WHO-recommended malaria tools.
Q: Could you describe progress of the vaccine pilot program in parts of Ghana, Kenya, and Malawi?
A: Since the pilot program began in 2019, the ministries of health in these countries have administered more than 2.3 million doses of the vaccine through routine immunization services. These numbers indicate strong community demand and acceptance for the vaccine, and we are grateful for the strong involvement of communities in the pilot.
Q: What has PATH’s specific role been with the pilots?
A: PATH is leading studies on the use and acceptability of RTS,S in vaccinating communities as well as research on the economics and impact of malaria vaccine implementation. We are finding that the vaccine is cost-effective and could have a considerable public health impact, averting one death for every 220 children vaccinated.
Q: What are the next steps following WHO recommendation of the vaccine for wider use?
A: Expanding access to the vaccine will require funding for—among other things—vaccine supply and rollout. As policymakers around the world consider next steps for RTS,S, we urge them to contribute financing to support use of the vaccine while maintaining other malaria control measures—because only through sustained, multipronged action will the world finally overcome malaria.