WHO announced yesterday (21st December) that they have added the malaria R21 vaccine to their pre-qualified list.

This is the regulatory step required for Gavi to begin their programmes, as previously discussed on the forum.

A good day!

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In your view, what is the next step?

This has some of 1Day's thoughts (though it was published before PQ happened). This tweet thread is briefer and has some more technical ideas. 

Big picture -- probably need to raise about $500 million to pay for distribution and need to get WHO/GAVI/UNICEF to announce a much more aggressive plan for implementation. Also need to do a ton of work in African countries to create the political will and technical plans for rapid rollout.

From an advocacy perspective, 1Day's main idea is to generate a ton of public attention to achieve the goals above (particularly the money) -- ideally by bringing in new philanthropic funders, though that may be unrealistic. But there will also be more targeted campaigns at the international institution and African country levels.

Current rollout plans are unclear, but the below probably gives the best sense of current international institution goals. 

As you can see, current vision doesn't get to the predicted steady state (80 million doses) until about 2027. Serum Institute can currently produce 100 million doses per year and already has on-hand material to make 20 million. About 80 million children are at risk of malaria and in the age range in which R21 was tested and demonstrated high efficacy. About 25 million are born each year. Each child requires 4 doses (3 doses the first year followed by a booster).

Optimistically, Gavi and partners do their thing and we get a nice efficient rollout across the relevant areas. But I have very limited knowledge of this space. I don't know what the bottlenecks or process here is.

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