Malaria vaccine: The road to Eldorado

There is a story about the city of Eldorado.  

El Dorado is a legendary place, a mythical city of gold supposedly located somewhere in South America. Much like our politicians, the king of this city was said to be so wealthy that he would cover himself in gold dust before diving into a sacred lake to wash it off. This legend, first recorded in the 16th century, captivated explorers and dreamers alike, leading to countless expeditions in search of this elusive city of riches. And while El Dorado has never been found, the legend continues to fascinate and inspire. It is a symbol of wealth, adventure and the human desire for something more.

In more ways than one, Eldorado reminds me very much of our dear Naija.

Anyway. Drum roll please!

Ladies and gentlemen, boys and girls, after many years of planning (and procrastination), the moment we have all been waiting for is finally here! Yes, let us put our hands together for the one and only – The malaria vaccine!

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Starting next week, Kebbi and Bayelsa states will begin vaccinating children aged 5 to 11 months. Somebody say, Hallelujah!

In October 2024, the Nigerian government took their first delivery of malaria vaccines. Designed to bolster already implemented interventions like the distribution of insecticide-treated nets to households, the vaccine will roll out in Kebbi and Bayelsa states. Over 800,000 doses are expected to be distributed during this initial phase.

Nigeria’s Minister of Health and Social Welfare, Prof Ali Pate, while receiving the vaccines in Abuja last month, said the arrival of the malaria vaccine was a huge step in the country’s effort to reduce malaria cases and related deaths. The malaria vaccine, which requires four doses, will be administered to children under one year of age as part of Nigeria’s routine immunisation schedule.  

Hurray! Hurray! Hurray! This is a major milestone in the fight against malaria.

Where are my nay sayers? Where are those whose arguments are always, “Malaria is our problem? Why is the government focusing on cervical cancer instead? There is something fishy going on”

Well, my dears, there is nothing ‘fishy’ going on. The malaria vaccine just took its sweet time before coming home, no thanks to our lack of political will and nonchalance (other African countries have acquired it years before us). Anyway, it is better late than never, eh? Now that it is here, I beg you, in the name of all that is holy, to take your children for immunisation. Enough with the conspiracy theories, abeg!

The World Health Organisation (WHO’s) 2023 World Malaria Report states that Nigeria accounts for 27 per cent of the global malaria burden – the highest in the world – with a national prevalence rate of 22 per cent in children five years and below. In the North-East, the figure is as high as 49 per cent.

Everyday we go to the hospital and all we treat is malaria. In the emergency paediatric units, children are brought in with all manner of complications: some are brought in unconscious due to cerebral malaria, others are carried in their parents’ arms, convulsing, while others are brought in with yellow eyes and even yellower urine.

Some will need dialysis from acute kidney failure while some will require multiple blood transfusions due to anaemia. And sadly, many will lose their lives.

Everyday, the same story – malaria, malaria, malaria.

According to the 2023 World Malaria Report, nearly 200,000 people died from malaria in Nigeria in 2023. Nigeria is one of four countries that account for nearly half of all global malaria cases. The other countries are Democratic Republic of Congo, Uganda and Mozambique. Of course, Nigeria’s case is the highest – 27 per cent of malaria cases ended in mortality.

However, while death is very painful, it is not the only complication. Malaria hampers productivity and slows down the national economy as a result of illness. Therefore, the amount lost to this disease every year is surely more than what is being projected. Whether through the number of people who fall ill and can’t go to work, thereby reducing productivity or from the staggering amount of money spent treating malaria cases, the effect of malaria on the economy cannot be quantified.

I have lost count of the number of times parents lamented the cost of hospital admission. How they can’t afford N5,000 to be admitted. How they cry about the cost of dialysis. How they suffer from the cost of oxygen. How they break down when they hear the cost of ICU. How they go into financial ruin trying to save the life of a beloved child.

It is not easy, wallahi.

When the malaria vaccine delivery was announced, many asked the question – ‘Why so late?’

The development of malaria vaccines has taken almost 60 years of hard work (almost as old as Naija). The journey that started in the early 1960s was inspired by the remarkable success of vaccines against polio, measles, diphtheria, tetanus, rabies and other diseases. The complete eradication of smallpox in humans proved the potential of this approach to reduce the global burden of infectious diseases.

Initial attempts to develop a malaria vaccine resulted in great frustration. Researchers realised that vaccines against this disease would be challenging to develop, and it became increasingly clear that it is due to a clever parasite. Impediments to successful malaria vaccination are multi-factorial. The main difficulties were the malaria parasite’s (P. falciparum) extremely complex biology, life cycle and genome, in addition to the parasite’s evasion of the human immune system and the absence of sterile immunity to the disease.

It is also noteworthy that parasites are difficult to develop vaccines against. Moreover, malaria has been mutating for 30 million years, and after a person has contracted malaria, they can only acquire partial immunity, unlike a virus which can elicit solid immunity. To overcome this obstacle, efforts were directed at obtaining many types of parasite antigens (mainly proteins) or from vectors trying to induce a protective immune response. 

To cut science short: the road to malaria vaccine has not been easy.

But we are here. Alhamdulillah. Soon, it will be implemented in all states across Nigeria. Tell a friend to tell another friend – let your children get the vaccine.