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WHO endorses use of world’s first malaria vaccine in Africa

Africa

WHO endorses use of world’s first malaria vaccine in Africa

The World Health Organization has recommended the widespread rollout of the first malaria vaccine, in a move experts hope could save tens of thousands of children’s lives each year across Africa.

Hailing “an historic day”, the WHO’s director general, Dr Tedros Adhanom Ghebreyesus, said that after a successful pilot programme in three African countries the RTS,S vaccine should be made available more widely.

“I started my career as a malaria researcher, and I longed for the day that we would have an effective vaccine against this ancient and terrible disease. And today is that day, an historic day. Today, the WHO is recommending the broad use of the world’s first malaria vaccine,” Tedros said at a press conference in Geneva.

The RTS,S vaccine, also known as Mosquirix, was developed by the British pharmaceutical company GlaxoSmithKline (GSK), and has been administered to more than 800,000 children in Ghana, Kenya and Malawi since the pilot programme began in 2019.

The vaccine, which went through lengthy clinical trials, has limited efficacy, preventing 39% of malaria cases and 29% of severe malaria cases among small children in Africa over four years of trials.

However, in August a study led by the London School of Hygiene & Tropical Medicine (LSHTM) found that when young children were given both the RTS,S and antimalarial drugs there was a 70% reduction in hospitalisation or death.

“Using this vaccine in addition to existing tools to prevent malaria could save tens of thousands of young lives each year,” said Tedros on Wednesday. “It is safe. It significantly reduces life-threatening, severe malaria, and we estimate it to be highly cost-effective.”

He added: “Malaria has been with us for millennia, and the dream of a malaria vaccine has been a long-held, but unattainable dream. Today, the RTS,S malaria vaccine, more than 30 years in the making, changes the course of public health history. We still have a very long road to travel. But this is a long stride down that road.”

There have been fears that decades of progress towards ending malaria has stalled, with some countries, such as Eritrea and Sudan, seeing significant resurgences in recent years. In 2019, 409,000 people died from the mosquito-borne parasite disease, most of them in Africa. More than 270,000 of the victims were children under five.

But experts hope the WHO’s announcement will re-energise the race to find other vaccines, a quest that has been going on for almost a century.

Earlier this year, scientists at the Jenner Institute of Oxford University said a vaccine they had developed had shown results that would make it the first to meet the WHO goal of 75% efficacy. Over 12 months the vaccine showed up to 77% efficacy in a trial of 450 children in Burkina Faso. Larger trials are now beginning, involving 4,800 children in four countries.

Thomas Breuer, GSK’s chief global health officer, said: “GSK is proud that RTS,S, our groundbreaking malaria vaccine, developed over decades by our teams and partners, can now be made available to children across sub-Saharan Africa.

“This long-awaited landmark decision can reinvigorate the fight against malaria in the region at a time when progress on malaria control has stalled. Both real-world evidence and clinical trial data show that RTS,S, alongside other malaria prevention measures, has the potential to save hundreds of thousands of lives.”

GSK said it was committed to supplying up to 15m doses a year at no more than 5% above the cost of production, and would now work with partners, funders and governments to support additional supply of the vaccine.

Professor Sir Brian Greenwood from the LSHTM said: “The RTS,S vaccine does not provide complete protection but this decision is testament to the global health community’s drive and vision to find a way forward. As part of a tailored approach it has great potential to reduce death and illness in high burden areas, especially when combined with other interventions such as seasonal malaria chemoprevention and bed nets, and be a huge boost to malaria control efforts.”

Gareth Jenkins, director of advocacy at the charity Malaria No More, said the announcement was “a truly historic moment” and “another critical step in building our armoury of weapons” against malaria.

Noting the role played by GSK in the development of the RTS,S vaccine, he called on the UK government to continue to invest in cutting-edge research that could “finally bring about a zero-malaria world”.

“This complex, but preventable and treatable disease, causes hundreds of millions of infections each year, risking lives and livelihoods, trapping people in poverty in some of the poorest countries in Africa, and creating ‘disease blind spots’ which threaten our own health security at home. If we save lives from malaria today, we can also protect ourselves against the diseases of tomorrow,” he said.

Health

Lagos to convert General Hospital to eye centre

The Lagos State Commissioner for Health, Prof. Akin Abayomi, says the state government will designate one of its general hospitals as a centre for ophthalmic specialty to improve care for patients with eye conditions.

Abayomi said this during the 4th Annual General Meeting and Scientific Conference of the Africa Retina Society on Thursday in Lagos.

The News Agency of Nigeria (NAN) reports that the event was themed, “Upscaling Retinal Services in a Resource-Constrained Economy.”

Abayomi said the centre would provide a world-class diagnostic, medical, surgical and ophthalmic services in Lagos and Nigeria.

He stressed that the state would prioritise eye health, noting that the state was working on developing screening capacity of all its primary healthcare facilities to detect eye diseases early.

“The conditions that affect the eyes very much reflect the conditions of the community in which you live. HIV, for example, was a major problem in South Africa, and I certainly experienced the impact of HIV on our day-to-day medicine and practice.

“Here in Nigeria, we have other things. We have hypertension, diabetes, sickle cell, and lots of trauma. These are the kinds of things that we see in our clinics here in Lagos and in Nigeria.

“We need to be able to understand how these prevailing conditions really affect us,” he said.

The commissioner further said that efforts are ongoing to promote eye screening, especially in schools, starting with the training of teachers to detect students exhibiting challenges with their vision.

He added that the state would leverage the social health insurance to screen, detect and treat eye diseases as patients presents at health facilities.

The commissioner further said the state would strengthen public awareness and understanding on eye health, especially glaucoma and visual acuity.

Abayomi disclosed that the state through its Ministry of Health had forged a partnership with the Chagoury Group
to develop a specialist eye hospital in Lagos to boost access to eye services.

He acknowledged that ophthalmology was equipment-intensive, stressing that government would pay attention to that and human resources to enable practitioners make appropriate diagnosis, and treatment to reverse medical tourism.

Earlier, Prof. Linda Visser, Head, Division of Ophthalmology Stellenbosch University, South Africa, called on policy makers to formulate policies that would integrate eye screening into diabetes care from the primary healthcare level, noting that cases of diabetic retinopathy was on the increase among Africans.

Diabetic retinopathy (DR) is a chronic progressive disease of the retinal capillaries (small blood vessels) associated with prolonged raised blood glucose levels in people with diabetes.

Visser cited data from International Diabetes Foundation that showed that 537 million adults aged 20 to 79 years are living with diabetes globally, a number that was predicted to reach 1.3 billion in 50 years.

“The high prevalence of type 2 diabetes continues to rise worldwide and is particularly rapid in low- and middle income countries.

“Most of these countries have limited availability and affordability of healthcare services for screening and treating diabetes-related complications, such as retinopathy, to prevent vision loss,”

According to her, all persons with diabetes are at risk of developing DR, however, those with poor blood glucose and blood pressure management and hyperlipidaemia are most at risk.

Visser, Past President, Vitreoretinal Society of South Africa, emphasised that early detection would lead to timely treatment of DR, which could prevent 95 per cent of vision impairment and blindness.

Also, Dr Asiwome Seneadza, Chairman, Africa Retina Society, said that the theme was timely and critical as efforts are made to navigate the complexities and challenges in delivering advanced retinal care across the continent.

Seneadza said, “That’s why we are advocating for improved diabetes care and regular retinal screening made available and accessible for every individual living with diabetes,” he said.

Similarly, Prof. Bassey Fiebai, Chairman, Vitreo Retinal Society of Nigeria, said the meeting was critical to proffering solutions to the challenge of offering standard retina care, improving outcomes and reducing visual loss from retina related disorders among low to medium income countries.

Fiebai said that the government plays a critical role in providing funding, training of personnel, provision of equipment to improve screening, detection and treatment of retinopathy disease.

The professor noted that retina specialists are few in Nigeria, placing the figure at about 100, stressing that it was inadequate to cater to the teeming population who require eye care.

“Right now in the country, we have just a little over 100 retina specialists. And we know that the population of Nigeria is about 230 million.

“So we’re looking at a situation in which one retina specialist is supposed to cater for 2.3 million people. How does anyone cope?” she queried.

NAN reports that the Annual General Meeting and Scientific Conference of the Africa Retina Society which began on June 26 to June 28, had participants from various African countries brainstorm on enhancing retinal care.

(NAN)

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Health

Cholera outbreak: Tinubu sets up presidential committee to oversee emergency operation centre

President Bola Tinubu has directed the setting up of a presidential committee to oversee the Cholera Emergency Operation Centre, operated by the National Centre For Disease Control.

The Minister of Health, Ali Pate, made this known on Tuesday after the Federal Executive Council meeting chaired by President Tinubu at the State House, Abuja.

He added that the committee’s effort is in addition to state government support to ensure Nigeria makes progress in reducing open defecation.

“The Council then approved a cabinet committee comprising the federal ministries of Health, Finance,Water Resources, Environment, Youth, Aviation, Education because some of our children will be returning to school . In addition to this, the state government, we will co-opt, so that Nigeria makes progress in reducing open defecation because cholera is a developmental issue that requires a multi-sectoral approach.

“The President directed that a cabinet committee be set up to oversee what the emergency operation centre led by NCDC is doing and for the resources to be provided complemented by the state government,” he said.

Pate further disclosed: “At the moment about 31 states have recorded 1528 cases and 53 deaths in Nigeria. That is what we are working through the Emergency Operation Centre that was activated by NCDC on Monday.

“Now we have a cholera outbreak and we discussed extensively in the Council in addition to a new emergence of Yellow Fever specifically in Bayelsa State.

“On cholera we are in the middle of the 7th pandemic globally which is decades in the making. In 2022, the world had almost 500,000 cases of cholera so it is not only peculiar to Nigeria. In 2023 almost 700,000 cases of cholera were reported by the World Health Organization.

“This year more than 200,000 cases have occurred in five regions of the World.”

He emphasised that a multi sectoral approach is required to tackle the outbreak .

“Resources were deployed to 21 states to help them respond to cholera. We are improving awareness of population, handwashing, hygiene sanitation, in addition to treatment with drugs, and intravenous fluids,” he added.

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Health

NCDC reports 1,598 cases of cholera across the country

The Nigeria Centre for Disease Control and Prevention, NCDC, has reported 1,598 suspected cases of cholera across 107 local government areas.

The cholera outbreak is characterised by a case fatality rate of 3.5 per cent, significantly higher than the national expected average of one per cent, underscoring the severity of the situation.

The Director-General of NCDC, Dr Jide Idris, disclosed this on Monday in Abuja while providing an update on the cholera epidemiological situation in Nigeria and ongoing prevention and response efforts at the national and sub-national levels.

Cholera is a severe diarrheal illness caused by the bacterium Vibrio cholerae. The disease remains a significant health challenge, especially in regions with inadequate sanitation and clean water access.

Understanding the transmission mechanism of cholera is crucial to curbing its spread and implementing effective prevention measures.

Idris said: “Government is deeply concerned about the rapid spread and higher-than-expected mortality rate, indicating a more lethal outbreak.”

He emphasised that the fatalities represented significant personal losses, including those of family members, spouses, parents and healthcare workers.

“This situation can be compounded as the rainy season intensifies,” he added.

He disclosed that Lagos State accounted for the highest number of deaths with 29, followed by Rivers with eight, Abia and Delta with four each, Katsina with three, Bayelsa with two and Kano, Nasarawa and Cross River with one each.

He added: “This alarming trend highlights the urgent need for coordinated response to prevent further escalation of the crisis. Sixteen states accounted for 90 per cent of the confirmed cases, with Lagos being the epicentre of the outbreak. Lagos State, having the highest number of cases, has received significant focus, with ongoing support and resources directed to manage the outbreak effectively.”

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