We have made good progress in the last two months and are now in the final stages of discussion with several significant distributions.
We have identified co-funding and distribution partners and details are being discussed with these partners and the relevant National Malaria Control Programmes (NMCPs)
We are planning new net distributions during 2015 to 2017. In several cases, where we are considering a particularly significant quantity of nets, we are looking at funding distributions in three phases:
- 2015/early 2016 - pilot distributions of between 100,000 and 200,000 nets
- 2016 - 1 to 2 million nets
- 2017 - 1 to several million further nets.
This strucutre has the benefit of allowing relationships to be established and developed with NMCPs and partners with whom we have not worked previously, and demonstrates AMF's support is long term.
It also allows us to manage risk and structure our support to provide an incentive to all parties involved to ensure the distributions run as agreed and are successful.
Reaching and finalising agreements - particularly this last stage - can take several months and there is always the possibility an individual agreement will not be finalised.
Our updates share as candidly as we can the progress made.
We consider potential distributions three years ahead as this matches the planning cycle of NMCPs and the advance period in which they seek commitments for support. There are also regions where distributions are needed on a shorter timescale, and we act to cover them. More information via Planning horizon and Allocating donations.
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Dowa distribution of 396,900 nets, Weeks 1 to 3
Summary
- The distribution is currently underway, having started on 23 Mar 15
- Problems with transport delayed the distribution by a month
- The distribution is expected to be completed by the end of May
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Everyone involved in malaria control has a fervent wish a malaria vaccine is found.
The following information is taken from an article that appeared in The Pharmaceutical Journal, 9/16 May 2015, Vol 294, No 7861/2, online | URI: 20068442, published online on 6th May 2015.
Summary
- The first candidate malaria vaccine to reach phase III clinical trials, RTS,S/AS01, is not as effective at protecting young African children against the disease as was hoped.
- Episodes of malaria reduced by just over a third (36%) in children who received three doses of RTS,S/AS01 plus a booster.
- Researchers who conducted the trial say the vaccine is still worth deploying because millions of children could benefit from vaccination in areas of high transmission.
- Others have said the assertion the vaccine may be worth deploying in some settings because it prevented large numbers of uncomplicated cases was controversial.
Detail
- Episodes of malaria reduced by just over a third (36%) in children who received three doses of RTS,S/AS01 plus a booster, and by 28% in children who did not receive the booster. Vaccine was less effective in infants. No significant protection against severe disease. Meningitis occurred more frequently in children given the vaccine.
- Researchers who conducted the trial say the vaccine is still worth deploying because millions of children could benefit from vaccination in areas of high transmission.
- Brian Greenwood, a researcher in tropical medicine at the London School of Hygiene and Tropical Medicine, and involved in the trial, says: “Despite the falling efficacy over time, there is still a clear benefit from RTS,S/AS01. Given that there were an estimated 198 million malaria cases in 2013, this level of efficacy potentially translates into millions of cases of malaria in children being prevented.”
- Adrian Hill, director of the Jenner Institute at the University of Oxford, says the assertion that the vaccine may be worth deploying in some settings because it prevented large numbers of uncomplicated cases was controversial. “There was no impact on malaria mortality and no significant effect on severe malaria: non-significant reductions of just 1% and 10% were observed in the children and infants studied over the full trial period using a three dose regimen. This is clearly lower than the efficacy of impregnated bed nets.”
- New evidence of a rebound in malaria susceptibility after vaccination was “worrying”, he adds. “After 20 months, vaccinated children who were not boosted showed an increased risk of severe malaria over the next 27 months compared with non-vaccinated controls. It should be possible to make the vaccine more effective in some settings, but that will probably increase delivery costs substantially.”
- The safety and efficacy of RTS,S/AS01 is being reviewed by the European Medicines Agency’s (EMA’s) Committee for Medicinal Products for Human Use (CHMP). An opinion is expected in the second half of 2015.
- If a positive opinion is obtained and the vaccine is pre-qualified by the WHO, malaria endemic countries can then decide whether to license and use the vaccine.
- The price of the vaccine has yet to be set. GSK committed to setting a price that covers costs of manufacturing the vaccine and a small return of 5% to be reinvested in R&D for next generation malaria vaccines.
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