Malaria shots for children across Africa will have 'great impact' says Ghana doctor
Dr. Kwame Amponsa-Achiano says the WHO recommendation will help in the fight against malaria in Africa
On Wednesday, the World Health Organization endorsed a malaria vaccine for use throughout Africa, welcome news to Dr. Kwame Amponsa-Achiano, who leads Ghana's malaria vaccine pilot program.
"I was very, very excited," he told As It Happens host Carol Off about the moment he heard the news.
Mosquirix is a vaccine developed by British drugmaker GlaxoSmithKline (GSK). Since 2019, 2.3 million doses of it have been administered to infants in Ghana, Kenya and Malawi in a large-scale pilot program co-ordinated by WHO.
"It's not just about the vaccine alone, but the vaccine is adding to already existing interventions like the insecticide-treated nets," said Dr. Amponsa-Achiano, adding that it will join efforts to eradicate mosquitoes and other drugs in the fight against malaria.
Here is part of his conversation with Carol Off.
Dr. Amponsa-Achiano, what does it mean for you to hear the news WHO has endorsed this vaccine for malaria?
I was driving at the time, I quickly parked and started calling a couple of friends for us to look at the hard work we had done and that we were very happy. And very excited.
How did your colleagues react when you all talked about this?
I remember one of them, we had a chat on WhatsApp, one of my big people. He said, "Oh, this has happened in our lifetime." That was the exclamation.
In your lifetime, what have you seen of the effects of malaria?
I myself suffered it, and I attended [to] quite a lot of children, in my early days as a doctor. Working in a remote area in the northern part of the country, I was glued to my ward and that was a children's ward and it was quite difficult sometimes, especially around the rainy season when malaria was at its peak. It was quite challenging.
But do you remember what it was like to have malaria?
You lose school days, you are not of yourself. You get admitted sometimes, and this is not a pleasant feeling at all. Sometimes you feel like you are dying.
We saw a malaria vaccine [as] very, very far away. It was as if it was impossible.-Dr. Kwame Amponsa-Achiano, lead on Ghana's malaria vaccine pilot program
And you did see, I'm sure, people who did die of malaria.
Oh, definitely I did.
We made a lot of attempts to revive some of them, but of course, those who had come very, very late ... sometime it was difficult to save them.
How often did you think, "If only we had some kind of vaccine, if only we had some immunization?" Is that something you and the other doctors talked about?
Yes, it's something we've been discussing, even as students. We saw a malaria vaccine [as] very, very far away. It was as if it was impossible.
So when the news came in 2014, 2015 that there was a vaccine that had a lot of potential and especially after receiving the positive opinion from the European Medicines Agency, I was particularly excited to be part of the pilot after they had done the clinical trials in 2014. So that seemed impossible, but now it's a reality.
This work you did with malaria, is that what perhaps inspired you to become a doctor?
What actually inspired me to become a doctor was the fact that I was sick myself in my childhood. I used to be very sick, very often.
Have you been able to make the difference that you'd hoped?
I think so. But it... will be for my peers and colleagues to judge.
I feel that I have done something over time to help not just in malaria, but especially in other infectious diseases and even non-infectious diseases as well. I believe that I have brightened my corner.
We're seeing with COVID-19 how quickly there was a vaccine... and a very effective one. Why do you think it's taken so long to develop some kind of vaccine against malaria?
So we are talking [about] very different organisms. One is a virus, the other is a parasite. Very complex indeed, which has a lifecycle both in humans and in mosquitoes. And this is a very elusive, invasive parasite for which reason it has been very, very difficult.
You know, the virus, I believe as a scientist will tell us, is very simple. One can easily do the genomic sequencing for which we can have a blueprint for production of a vaccine. But the parasite is quite a tricky one.
And even with this vaccine, it's not as effective as [the] COVID vaccines... this one is about 30 percent effective right? There are only about three or four out of 10 cases of malaria that would actually be prevented. Is that correct?
That is correct, but that is moderately efficacious, and we have demonstrated in real life and what we did was more of trying to see if it was possible to incorporate these vaccines into the routine.
But of course, you don't look just at the efficacy. You also look at how the disease has been behaving in terms of the numbers of people that are affected.
If you look at malaria, the prevalence of malaria is very high. You can have about 40 out of 100 ... prevalence in a particular geographic area, and that is quite high. So if you have a vaccine that is moderately efficacious and not just that vaccine, but you are adding on to the existing interventions, then obviously it's good news, it's exciting for us. What it means is that the impact will be great.
It also takes a number of shots, doesn't it? Because it requires about four ... doses over ...the first year and a half of a child's life. So how difficult is that going to be and how costly would that be in order to administer an inoculation programme like that?
So that is why we did a pilot to see how it fares within the the routine, and it's been demonstrated that it is possible.
The studies have shown that it is quite cost-effective in terms of the impact that it will have eventually. And so I would say that it is doable. It can be given in three doses. And then of course, the fourth dose, which is more or less that booster can be given at around two years.
How long before you'll see the effect? To see that children will not have to suffer with malaria the way you did as a child?
We have seen it over the past few years, two and half years or so, in those selected districts and regions that we intervened [in] and having demonstrated this, we know that when we scale up then obviously the impact would even be felt more.
Of course, it would depend on the country's policy. It also would depend on the kind of technical guidelines we get from W.H.O. and allied partners as to how to do it, and then also with support for financing. I believe that in the next couple of years, we [will] see quite some great strides in malaria control.
Written by Andrea Bellemare with files from Reuters. Produced by Niza Lyapa Nondo. This Q&A has been edited and condensed.
