Why Nigeria was excluded from malaria vaccine allocation, says GAVI

 

Fresh facts have emerged on why Nigeria was excluded from the allocation of the 18 million doses of the first-ever RTS,S/AS01 malaria vaccine from 2023 to 2025.

Sunday PUNCH gathered that Nigeria’s refusal to meet the deadline for the second window application in January disqualified it from getting allocation.

It was learnt that allocations were determined through the application of the principles outlined in the framework for allocation of limited malaria vaccine supply, which prioritises the allocation of doses to areas of highest need, where the risk of malaria and death among children are highest.

The malaria vaccine implementation programme countries – Ghana, Kenya and Malawi will receive doses to continue vaccinations in pilot areas.

Allocations were also made to Benin, Burkina Faso, Burundi, Cameroon, the Democratic Republic of the Congo, Liberia, Niger, Sierra Leone and Uganda.

However, Nigeria was not among the countries that would receive the vaccine, despite having the highest malaria death rate in the world.

The World Health Organisation in 2021 recommended the widespread use of the RTS,S/AS01 (RTS,S) malaria vaccine among children in sub-Saharan Africa and other regions with moderate to high Plasmodium falciparum malaria transmission.

Four African countries accounted for just over half of all malaria deaths worldwide: Nigeria (31.3 per cent), the Democratic Republic of the Congo (12.6 per cent), the United Republic of Tanzania (4.1 per cent), and Niger (3.9 per cent).

Meanwhile, in a response to an email inquiry, Gavi, an organisation working to increase access to immunisation in poor countries, told our correspondent that the allocations announced were for countries that applied in the January window.

Gavi opened its first window of applications for support in July 2022, which covered three countries – Kenya, Ghana and Malawi.

A second window for applications, open to all other countries, including Nigeria, was announced at the end of 2022, with a deadline of January 17, 2023, but Nigeria failed to meet the deadline.

Responding to an inquiry by our correspondent, Gavi spokesperson, Evan O’Connell said, “Nigeria applied for vaccine support in our April window. The application was recently confirmed by Gavi’s Independent Review Committee which means we can move forward at full speed to ensure new supply will reach Nigerians as soon as it is available.”

Asked if Nigeria would get the vaccine by 2024, O’Connell said, the timeline would depend on additional available supply, “but we’re doing what we can to ensure Nigerian kids can access the vaccine as soon as possible.”

Experts fear that Nigeria may not get the vaccine by April 2024 as stated by the former Minister of Health, Dr Osagie Ehanire, since the first doses of the vaccine were expected to arrive in the 12 countries during the last quarter of 2023, while the countries are to start rolling them out by early 2024.

Ehanire, during the World Malaria Day in April said, “The country has successfully submitted an application to Gavi for the  RTS,S/AS01 vaccine allocation. This is expected to be in-country by April 2024.”

Speaking on the implications of the delay, a professor of Public Health at the University of Ilorin, Kwara State, Tanimola Akande, said the decision to exclude Nigeria from the list of 12 African countries to benefit from malaria vaccine must have been taken by Gavi and WHO based on criteria for the roll-out of the vaccine and the limited quantity of the vaccine available.

He added, “The implication of this is that eradication of malaria in Nigeria will be delayed a little further when compared with countries benefiting from the vaccines.

“Nigeria would need to step up other preventive measures pending when it receives supplies of the vaccines. The vaccines will arrive in the 12 countries in the last quarter of 2023 and deployed in 2024. I hope the production will be fast enough for Nigeria to benefit from the vaccines later in 2024. I am sure the WHO and other bodies will be working on ensuring that Nigeria benefits as soon as possible.”