Oxford vaccine developer criticises WHO’s mid-2024 target for malaria shot

One of the key scientists behind Oxford university’s malaria vaccine has criticised the World Health Organization’s lack of “urgency” after the global health body targeted mid-2024 for distribution of the jab.

Adrian Hill said the health body had not consulted the university before disclosing the planned timeframe on Monday when it recommended the R21/Matrix-M vaccine for use in children.

Health experts see the shot as a game-changer that will help combat the tropical disease. Oxford’s partnership with the Serum Institute of India, the world’s largest vaccine maker by doses, gives it much bigger production capacity than pharma group GSK has for its RTS,S shot, the first malaria vaccine approved for use in 2021.

“Why would you allow children to die instead of distributing the vaccine? There’s no sensible answer to that — of course you wouldn’t,” Hill told the Financial Times. The SII said it “already” had capacity to produce 100mn doses annually.

“Hearing this [the mid-2024 target] from the director-general at a press conference was news to everybody at Oxford,” said Hill, adding that he was informed last week that a group of WHO experts had discussed plans to distribute R21 to about 20 countries in the first quarter of 2024.

“There’s plenty of vaccine, let’s get it out there this year. We’ve done our best to answer huge amounts of questions, none of which a mother with a child at risk of malaria would be interested in.”

Malaria, which is caused by parasites transmitted by mosquitoes, is both preventable and curable but remains a significant global health threat. More than 240mn cases worldwide were recorded in 2021. According to Unicef, a child under five dies of malaria nearly every minute.

Hill, director of the university’s Jenner Institute, compared the timeframe with the swift rollout of the first Covid vaccines, which were distributed “within weeks” of approval.

“We’d like to see the same importance given to the malaria vaccine for children in Africa. We don’t want them sitting in a fridge in India,” he said. “We don’t think this would be fair to rural African countries if they were not provided with the same rapidity of review and supply.”

The SII said: “We have manufactured more than 20mn doses, with a current annual capacity of 100mn doses. We will wait for further instructions from the WHO for pre-qualification. We expect the vaccine to be rolled out [by global vaccine alliance Gavi and Unicef] by the first or second quarter of next year.”

The WHO declined to comment on whether it had shared the mid-2024 timeline with the SII and Oxford ahead of Monday’s announcement, but said: “We fully agree that everything should be done to expedite the use of life-saving malaria vaccines.” 

“WHO has pushed hard to get the R21 vaccine reviewed thoroughly by experts . . . increasing supply and getting the vaccine to children is a top priority,” said spokeswoman Margaret Harris. “We expect [R21] to fill the supply gap to meet the considerable public health need and have high impact.”

Harris said the timeline was a “conservative estimate” based on “the many moving parts and work of partners required to make this happen”, including for pre-qualification, a separate, confidential, WHO-led process that she said was “well on the way” to completion.

“We are working — and have been well before this announcement — to do our utmost to get this vaccine to children much earlier . . . ideally well before the timeline” announced on Monday, she said, adding that “safety, quality and trust” must not be compromised in the rollout.