No Child Left Behind: Accelerate Malaria Vaccine Distribution!

My post What is an Emergency? The Case for Rapid Malaria Vaccination, galvanized the great team at 1DaySooner. Here is Zacharia Kafuko writing at Foreign Policy:

Right now, enough material to make 20 million doses of a lifesaving malaria vaccine is sitting on a shelf in India, expected to go unused until mid-2024. Extrapolating from estimates by researchers at Imperial College London, these doses—enough for 5 million children—could save more than 31,000 lives, at a cost of a little more than $3,000 per life. But current plans by the World Health Organization to distribute the vaccine are unclear and have been criticized as lacking urgency.

…Vaccine deployment and licensure is an incredibly complex scientific, legal, and logistical process involving numerous parties across international borders. Roughly speaking, after the WHO recommends vaccines (such as R21), it must also undertake a prequalification process and receive recommendations from its Strategic Advisory Group of Experts before UNICEF is allowed to purchase vaccines. Then Gavi—a public-private global health alliance—can facilitate delivery by national governments, which must propose their anticipated demand to Gavi and make plans to distribute the vaccines.

Prequalification can take as long as 270 days after approval. However, the COVID-19 vaccines were rolled out within weeks of WHO’s approval, using the separate EUL process rather than the more standard prequalification process that R21 is now undergoing.

For COVID-19 vaccines, EUL was available because the pandemic was undeniably an emergency. Given the staggering scale of deaths of children in sub-Saharan Africa every year, shouldn’t we also be treating malaria vaccine deployment as an emergency?

The R21 malaria vaccine does not legally qualify for EUL because malaria already has a preventive and curative toolkit available. My concern is that this normalizes the deaths of hundreds of thousands of children each year in Africa.

We can move more quickly and save more lives, if we have the will.