Oxford launch of malaria vaccine might have ‘main’ impression on sub-Saharan Africa, says economist

Close-up of a yellow fever mosquito biting human skin. It is a Culicidae vector of malaria, yellow fever, chikungunya, dengue and Zika virus in Brazil locally known as Mosquito da Dengue.

João Paulo Burini | moment | Getty Images

Nigeria this week joined Ghana in tentatively approving a new malaria vaccine being developed by Oxford University scientists, potentially paving the way to saving millions of lives and improving Africa’s long-term economic prospects.

Africa’s largest economy, which accounts for 31.3% of all malaria deaths worldwide according to the World Health Organization, on Tuesday granted regulatory approval to roll out the R21/Matrix-M malaria vaccine, just a week after Ghana became the first country to give approval received the new shot.

Both nations have approved the vaccine for use in children between the ages of five and 36 months – the age group at highest risk of death from the mosquito-borne disease.

Oxford University’s Jenner Institute, which developed the vaccine, estimates that malaria kills about 800,000 people annually. These casualties are occurring predominantly in sub-Saharan Africa, where one in five childhood deaths is linked to the disease. The WHO estimated that in 2020 there were 241 million clinical cases of malaria, resulting in 627,000 deaths, mostly among children in Africa.

“This marks the culmination of 30 years of malaria vaccine research at Oxford with the development and delivery of a highly effective vaccine that can be supplied in reasonable volumes to the countries that need it most,” said Professor Adrian Hill, principal investigator at R21/ That’s what Matrix-M program and director of the Jenner Institute said when announcing Ghana’s regulatory approval on April 13.

A health worker vaccinates a child against malaria in Ndhiwa, Homabay County, western Kenya, Sept. 13, 2019, during the launch of Kenya’s malaria vaccine.

Brian Ongoro | AFP | Getty Images

In 2021, WHO approved GSK’s RTS,S malaria vaccine for rollout in sub-Saharan Africa, following pilot programs in Ghana, Kenya and Malawi that have tracked 800,000 children since 2019. Studies so far have shown that R21 will likely be much more effective in fighting the disease.

The R21 vaccine was the first of its kind to meet the WHO’s 75% efficacy target, although data from late-stage studies are still pending.

The vaccine is being manufactured by India’s Serum Institute, which it says has the capacity to supply around 200 million doses a year, while the vaccine is reportedly both cheap to manufacture and easy to transport.

“Big boost for long-term growth”

The US Centers for Disease Control and Prevention emphasizes that malaria is a major burden on many economies, especially as many poorer nations are among the hardest hit. As such, the disease “perpetuates a vicious circle of disease and poverty,” says the CDC.

While the economic impact of the vaccine will depend on a variety of currently unknown factors — such as logistical challenges, the extent to which immunity can be afforded to older children and adults, and the duration of immunity — a successful rollout “could have a large positive economic impact.” said William Jackson, chief emerging markets economist at Capital Economics.

Lower infant mortality will lower the population’s prevention and treatment costs, with various estimates suggesting that in hard-hit countries, about 3.8% of household income could be spent on such interventions, Jackson noted.

“It would also reduce the burden on public health spending. These resources could be freed for other consumption or conserved, which would increase the resource pool that can be used for domestic investment,” Jackson said in a research note Thursday.

“Lower infant mortality may also impact lower fertility rates in the region – which are currently very high. This, combined with less need to care for sick children, may in turn encourage more women to enter the labor market and increase participation and labor supply.”

Should the vaccine provide durable immunity to older children and adults, fewer malaria-related absences from school and work could increase human capital, or labor supply, Jackson suggested.

“Of course, the labor supply is not an obstacle to growth in the region. The working-age population is growing rapidly, but given that impact, combined with lower costs for prevention and treatment, the increase in GDP could be significant,” he added.

Jackson pointed to a study in the American Journal of Tropical Medicine and Hygiene that found that between 1965 and 1990, GDP per capita in malaria-intensive countries grew 1.3 percentage points less per year than in comparable countries. The same study showed that Jamaica and Taiwan saw growth acceleration of 0.2 to 0.8 percentage points per year compared to other companies after malaria eradication.

A more recent study published in 2019 models the impact of a vaccine covering 100% of children under the age of five in Ghana. This particular vaccine had an efficacy rate of 50% against clinical malaria – much lower than R21 – and 20% against malaria mortality. The study still estimated an increase in GDP growth of 0.5 percentage points per year over 30 years at this level of vaccine coverage and effectiveness.

“In short, the vaccine has the potential to be a major boost to long-term growth across much of Africa,” Jackson concluded.