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Nigeria is seeking to acquire a consignment of malaria vaccines through the second window of the World Health Organization (WHO).

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Nigeria is currently in pursuit of obtaining an allocation of malaria vaccines through the second supply window organized by the World Health Organization (WHO). This opportunity arises after missing out on the initial rollout, where 18 million doses were allocated to 12 other African countries.

In the first batch, Ghana, Kenya, and Malawi were allotted approximately 6.9 million doses for the Malaria Vaccine Implementation Programme (MVIP) that commenced in 2019, as outlined in the WHO’s Framework for Allocation of Limited Malaria Vaccine Supply. Over the next two years, eight additional countries, including Uganda, Burundi, Burkina Faso, the Democratic Republic of the Congo, Sierra Leone, Benin, Cameroon, and Liberia, are expected to receive more than 10.5 million doses to introduce the vaccine into their routine immunization programs.

Niger is anticipated to receive a partial supply of 565,000 doses out of the planned allocation of over 1 million. The WHO is actively exploring options to address the current scarcity of supply and aims to confirm the safety, efficacy, and adherence to manufacturing standards of the second malaria vaccine, R21/Matrix-M, currently under review. If it meets the necessary criteria, the vaccine could be recommended for use and potentially available by the first quarter of 2024.

Although conditional approval for the vaccine’s use in Nigeria was already granted by the National Agency for Food and Drug Administration and Control (NAFDAC) in April, a clinical trial for the malaria vaccine is also being conducted by the agency. Raphael Onyilo, the head of Advocacy and Communications at the National Malaria Elimination Programme (NMEP), confirmed ongoing efforts to ensure Nigeria’s inclusion in the next round of vaccine allocations, although the progress of these efforts was not specified.

During the first two application opportunities, Gavi, the Vaccine Alliance, approved only 14 out of 28 applications received for the RTS, S/AS01 malaria vaccine, which had received WHO approval for malaria prevention in children in 2022. Unfortunately, Nigeria was not among the approved countries, and the reasons for this exclusion remain unclear.

The demand for malaria vaccines is projected to reach 40 to 60 million doses annually by 2026, increasing to 80 to 100 million doses per year by 2030, according to the WHO. However, the available vaccine supply for the period 2023-2025 is currently limited to 18 million doses, falling short of the dose requirements for countries recommended for approval by Gavi IRC.

Malaria continues to be a major health concern in Africa, resulting in the deaths of nearly half a million children under the age of 5. Africa accounts for approximately 95 percent of global malaria cases and 96 percent of related deaths in 2021. Despite Nigeria having the highest burden of the disease in the world, accounting for over 23 percent of deaths according to the World Malaria Report 2020, the country’s inability to participate in clinical trials due to infrastructural limitations has hindered access to crucial vaccines.

The framework for allocation emphasizes considerations such as targeting countries with the greatest need based on malaria burden and risk of death among children. Many stakeholders believe Nigeria meets these criteria. The second priority principle is to maximize health impact by allocating vaccines to areas where the expected impact is highest, while the third principle focuses on achieving equity by prioritizing countries committed to fairness and addressing the needs of marginalized individuals and communities in their malaria vaccination programs.

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