Malaria vaccine trial starts

By Esther Nakkazi

Malawi has launched the world’s first malaria vaccine today in a pilot programme. Ghana and Kenya will introduce the vaccine in the coming weeks.

The vaccine RTS,S will be made available to children up to 2 years of age in 3 doses given between 5 and 9 months of age and the fourth dose at the 2nd birthday.

Malawi, Ghana, and Kenya were selected from among 10 African countries following a request by WHO for expressions of interest. These qualified because they had well-functioning malaria and immunization programmes, as well as areas with moderate to high malaria transmission.

“The malaria vaccine has the potential to save tens of thousands of children’s lives,” said Dr. Tedros Adhanom Ghebreyesus, the WHO Director-General.

Dr. Ghebreyesus said while there are many gains from bed nets and other measures to control malaria in the last 15 years progress has stalled and even reversed in some areas.

Thus the vaccine is a complementary malaria control tool – to be added to the WHO-recommended measures for malaria prevention, including the routine use of insecticide-treated bed nets, indoor spraying with insecticides, and the timely use of malaria testing and treatment.

“We need new solutions to get the malaria response back on track, and this vaccine gives us a promising tool to get there,” said Dr. Ghebreyesus.

Malaria is one of the world’s leading killers, killing one child every two minutes. Most of these deaths are in Africa, where more than 250,000 children die from malaria every year. Worldwide, malaria kills 435 000 people a year, most of them children.

The RTS,S vaccine has demonstrated that it can significantly reduce malaria in children. In clinical trials, the vaccine was found to prevent approximately 4 in 10 malaria cases, including 3 in 10 cases of life-threatening severe malaria.

“We know the power of vaccines to prevent killer diseases and reach children, including those who may not have immediate access to the doctors, nurses and health facilities,” said Dr. Matshidiso Moeti, WHO Regional Director for Africa.

Pilot programme;

“To step up the fight against malaria, we need every available tool. If this pilot shows that RTS,S is a cost-effective tool against malaria, it will help us save more children’s lives,” said Peter Sands, Executive Director of the Global Fund.

The pilot programme is designed to generate evidence and experience to inform WHO policy recommendations on the broader use of the RTS,S malaria vaccine.

“These pilots will be crucial to determine the part this vaccine could play in reducing the burden this disease continues to place on the world’s poorest countries,” Dr. Seth Berkley, CEO of Gavi.

GSK, the vaccine developer and manufacturer is donating up to 10 million vaccine doses for this pilot.

It aims to reach about 360,000 children per year across the three countries and will look at reductions in child deaths; vaccine uptake, including whether parents bring their children on time for the four required doses; and vaccine safety in the context of routine use.

Ministries of health will determine where the vaccine will be given; they will focus on areas with moderate-to-high malaria transmission, where the vaccine can have the greatest impact.

“This novel tool is the result of GSK employees collaborating with their partners, applying the latest in vaccine science to contribute to the fight against malaria,” said Dr. Thomas Breuer, Chief Medical Officer of GSK Vaccines.

He said they look forward to the results of the pilot, and in parallel, working with WHO and PATH to secure the vaccine’s sustained global health impact in the future.

Financing for the pilot programme has been mobilized through collaborations between Gavi, the Vaccine Alliance; the Global Fund to Fight AIDS, Tuberculosis, and Malaria; and Unitaid. Additionally, WHO, PATH and GSK are providing in-kind contributions.

“The malaria vaccine is a shining example of the kind of inter-agency coordination that we need. We look forward to learning how the vaccine can be integrated for greatest impact into our work,” said Lelio Marmora, Executive Director of Unitaid.

Experts warn farmers on late planting due to delayed rains

By Esther Nakkazi 

Agriculture experts from the International Maize and Wheat Improvement Center (CIMMYT) request the scale up of climate resilient seeds and smart innovations, including drought-tolerant seeds and soil and water conservation practices to mitigate the impact of the current drought affecting millions of farmers living in areas of eastern and southern Africa.

The U.S. National Weather Service’s Climate Prediction Center has just warned that abnormally dry conditions are affecting areas of eastern and southern Africa as well this year's El Niño, the second in a period of 3 years, has led to large pockets of drought across eastern and southern Africa.  

Although farmers have put off planting grains waiting for the long rains anticipated to start late April, experts from CIMMYT warn that the very late onset of the rainy season could lead to a poor cropping season and significantly reduce maize yields in farmers’ fields. 

Late planting may also expose maize crops to stronger attacks of pests like the fall armyworm, they say. Long rains usually arrive by mid- March but are late this time round.

Stephen Mugo, CIMMYT Africa regional representative, recommends that farmers shift to planting stress-resilient varieties, like early maturing maize varieties that just need 90 to 95 days to mature, instead of over four months for late maturing varieties. 

Seeds of such early maturing varieties are available from seed companies and agrodealers operating in maize growing areas.

"If more small farmers in Africa's drought-prone regions grow drought-tolerant varieties of maize and other staple crops, the farming communities will be better prepared for prolonged dry spells and inadequate rainfall,” says Mugo.

Crop diversification and more sustainable soil and water conservation practices are also recommended to improve soil fertility and structure and avoid soil compaction. When the rains finally come, run-off will be less, and soils will have more capacity to retain moisture, CIMMYT experts advise.

Moreover, research by CIMMYT shows that conservation agriculture, combined with a package of good agronomic practices, offers several benefits that contribute to yield increases of up to 38 percent.

 

CIMMYT works with the African seed sector and national partners to develop and deploy stress resilient maize and wheat varieties through initiatives like Stress Tolerant Maize for Africa and the Wheat rust resistant seed scaling in Ethiopia.

Measles cases on the rise says WHO

Press Release:

Measles cases have continued to climb into 2019. Preliminary global data shows that reported cases rose by 300 percent in the first three months of 2019, compared to the same period in 2018. This follows consecutive increases over the past two years.

While this data is provisional and not yet complete, it indicates a clear trend. Many countries are in the midst of sizeable measles outbreaks, with all regions of the world experiencing sustained rises in cases.

Current outbreaks include the Democratic Republic of the Congo, Ethiopia, Georgia, Kazakhstan, Kyrgyzstan, Madagascar, Myanmar, Philippines, Sudan, Thailand, and Ukraine, causing many deaths – mostly among young children.

Over recent months, spikes in case numbers have also occurred in countries with high overall vaccination coverage, including the United States of America as well as Israel, Thailand, and Tunisia, as the disease has spread fast among clusters of unvaccinated people.

Measles is one of the world’s most contagious diseases, with the potential to be extremely severe. In 2017, the most recent year for which estimates are available, it caused close to 110 000 deaths. Even in high-income countries, complications result in hospitalization in up to a quarter of cases and can lead to lifelong disability, from brain damage and blindness to hearing loss.

The disease is almost entirely preventable through two doses of a safe and effective vaccine. For several years, however, global coverage with the first dose of measles vaccine has stalled at 85 percent. This is still short of the 95 percent needed to prevent outbreaks, and leaves many people, in many communities, at risk. Second dose coverage, while increasing, stands at 67 percent.

With governments and partners such as the Measles & Rubella Initiative, Gavi, the Vaccine Alliance, UNICEF, and others, response operations are underway to bring country outbreaks under control, strengthen health services, and increase vaccine coverage.

After conducting emergency vaccination campaigns targeting 7 million children from 6 months through 9 years of age:

• Madagascar is now seeing overall declines in measles cases and deaths.
• In the Philippines, over 3 890 000 doses of the measles and rubella vaccine have been given to children aged under 5 years.
• In the Democratic Republic of the Congo, the country is preparing to launch a combined response with the polio vaccine.
• In collaboration with local health authorities, WHO and UNICEF conducted the nationwide measles and rubella vaccination campaign in Yemen reaching more than 11.6 million (90%) children aged 6 months–16 years across the country.

Responding to measles requires a range of approaches to ensure all children get their vaccines on time, with particular attention to access, quality, and affordability of primary care services. It will also take effective public-facing communication and engagement on the critical importance of vaccination and the dangers of the diseases they prevent.

WHO also recommends tailored approaches that ensure immunization services meet the needs of everyone – making sure that clinics are accessible to all areas, at the right times and to all population groups - especially those who face systemic discrimination and disadvantage.

Coverage of the 2nd vaccine dose also needs to increase globally, to maximize a population’s protection against the disease. Today, 25 countries still need to make the 2nd dose part of their essential immunization programme.

Statement from WHO