Rwanda: Why Rwanda Missed Out On Inaugural Malaria Vaccine

On Wednesday, July 5, the World Health Organization and GAVI, The Vaccine Alliance, announced that 12 countries across different regions in Africa are set to receive 18 million doses of the first-ever malaria vaccine over the next two years.

Despite having expressed enthusiasm about the vaccine during its development phases, Rwanda was not selected among the countries that will get the vaccine in the first two years.

A GAVI spokesperson told The New Times that the reason for this is that the vaccine roll-out is currently focusing on countries with the highest risk of malaria, and Rwanda is currently not among them.

"Due to limited vaccine supply, we are currently focused on rolling out the malaria vaccine to areas with the greatest need, where the risk of malaria illness and death among children is highest. Therefore, Rwanda hasn't applied at this stage, but GAVI will continue to open regular windows for countries to apply for malaria vaccine support," the spokesperson noted.

Ghana, Kenya and Malawi, Benin, Burkina Faso, Burundi, Cameroon, the Democratic Republic of the Congo, Liberia, Niger, Sierra Leone, and Uganda will be getting the vaccine first and are expected to introduce it into their immunisation programmes.

Speaking to The New Times, Dr Aimable Mbituyumuremyi, the manager of the malaria division at Rwanda Biomedical Center (RBC), talked about how the malaria situation in Rwanda has reduced in the past years.

"Based on the statistics, I don't think we should come among the first countries to receive the vaccine because the malaria burden in Rwanda has really reduced in terms of children who die of malaria or those who are affected by severe malaria," he said.

Statistics from RBC show that malaria cases declined from five million in 2016 to one million in 2021, in addition to a decrease in severe malaria from 18,000 in 2016 to less than 2,000 in 2021, while malaria-related deaths reduced from 700 in 2016 to 69 in 2021.

Dubbed RTS,S/AS01, the vaccine has been administered to more than 1.7 million children in Ghana, Kenya, and Malawi since 2019 and has been shown to be safe and effective, resulting in both a substantial reduction in severe malaria and a fall in child deaths.

At least 28 African countries have expressed interest in receiving the malaria vaccine.

"This vaccine has the potential to be very impactful in the fight against malaria, and when broadly deployed alongside other interventions, it can prevent tens of thousands of future deaths every year," said Thabani Maphosa, Managing Director of Country Programmes Delivery at GAVI.

"While we work with manufacturers to help ramp up supply, we need to make sure the doses that we do have are used as effectively as possible, which means applying all the learnings from our pilot programmes as we broaden out to a new total of 12 countries," he added.

Malaria remains one of Africa's deadliest diseases, killing nearly half a million children under the age of five, and accounting for approximately 95 per cent of global malaria cases and 96 per cent of deaths in 2021.

The annual global demand for malaria vaccines is estimated at 40-60 million doses by 2026 alone, growing to 80-100 million doses each year by 2030. In addition to the RTS,S/AS01 vaccine, it is expected that a second vaccine, R21/Matrix-M, developed by Oxford University and manufactured by Serum Institute of India (SII), could also be prequalified by WHO soon.

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