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Nigeria in $124m scramble for malaria vaccine

Nigeria is scrambling for $1.24 billion, about 0.4 percent of its 2024 budget, to procure the R21 malaria vaccine, the full cost to cover an estimated 31 million children aged five and below, BusinessDay analysis shows.

The vaccine jointly developed by the Oxford University and Serum Institute of India (SII) covers a three-dose course and a booster shot costing about $4 altogether.

The National Agency for Food and Drug Administration and Control gave conditional approval for the vaccine in April 2023, given its 71 percent efficacy rate and potential to prevent severe malaria illness in children.

But the federal government does not have immediate financing plans for procurement as the manufacturer plans to roll out about 25 million doses in the global market by May, Muhammad Ali Pate, Nigeria’s coordinating minister for Health and Social Welfare said has said.

He said a well-thought plan on how to generate funding with public health financing will be required to introduce the vaccine.

Currently, 68 percent of the financing for Nigeria’s vaccines are sponsored by global development partners, Pate said speaking during an interview on Channels on Sunday.

“When you introduce a new vaccine, you have to be considerate about who it is going to cover, how much will it cost, where the resource is going to come from, how much are our partners going to contribute and the fiscal space from the FG and the state,” Pate explained.

“The financing will take some time to organise including the infrastructure and the training.”

Considering Nigeria’s current fiscal reality, the minister hinted that a large meeting of key global partners is set to hold on May 3 to rethink the country’s malaria elimination strategy.

The goal is to examine how Nigeria can optimise various tools to fight its high malaria incidence including vaccines.

If the country can afford the vaccine, Pate believes it has to be co-utilised with other interventions related to malaria such as seasonal chemoprophylaxis, effective bed nets and the case management of malaria through the primary healthcare system.

According to the 2018 Nigeria Demographic and Health Survey (NDHS), the rate of malaria in children under five is about 23 percent.

Malaria remains one of Africa’s deadliest diseases, killing nearly half a million children under the age of 5, and accounting for approximately 95 percent of global malaria cases and 96 percent of deaths in 2021.

Nigeria carries the largest burden of the disease in the world, with more than 23 percent of deaths recorded according to the World Malaria Report 2020.

Annual global demand for malaria vaccines is estimated at 40 to 60 million doses by 2026 alone, growing to 80 to 100 million doses each year by 2030, according to WHO.

Adar Poonawalla, SII chief executive pledged to offer the R21 vaccines to the African market at $4 or less in the first year of roll out. It will drop a bit further as the pharmaceutical company scales up production, the CEO said in a report by AFP.

Poonawalla said the institute’s target is to roll out R21 in a few countries before the main malaria season starts in about six to seven months.

“Ideally we should have vaccinated the people most vulnerable at risk. That’s the target,” he said, adding that production would eventually reach 100 million R21 doses per year.

SII research and development director Umesh Shaligram said the vaccines would be shipped towards the end of April with deployment to start by May and June.

The vaccines will mostly be bought and distributed through the United Nations Children’s Fund (UNICEF) and Gavi, a global vaccine alliance.

Chad, Central African Republic, DR Congo, Mozambique and South Sudan will be the first five countries to receive R21 doses, a UNICEF spokesperson said.