The Ghana Health Service (GHS) and its development partners are set to expand the Malaria Vaccine Implementation Programme (MVIP) to 93 other districts across seven regions in Ghana, beginning December, 2022.  

Dr. Patrick Kuma Aboagye, the Director-General of the Ghana Health Service, who made this known at a media briefing in Accra, said 42 districts in seven out of the country’s 16 administrative regions had benefited from the MVIP Pilot since 2019. 

The seven implementation regions are; Ahafo, Bono, Bono East, Central, Oti, Upper East, and Volta. 

He said the planned expansion programme would be executed in phases targeting children below two years in the added districts, who would receive four doses of the vaccine each, at fixed intervals. 

This would start from the sixth, seventh, nineth and 18^th month after birth. 

 It is based on the recommendation of the National Immunisation Technical Advisory Group, following the World Health Organisation’s (WHO) endorsement of the vaccine for broader use in areas with moderate to high malaria transmission. 

Dr. Kuma Aboagye said the exact date for the commencement of the programme would soon be communicated to the public. 

He indicated that despite international efforts to scale-up existing malaria control interventions, about half of the world’s population remained at risk of the disease, causing hundreds and thousands of illnesses and deaths annually. 

“The WHO estimates that more than 90 percent of these deaths occur in Sub-Saharan Africa alone, mainly among children under five years old. In Ghana, malaria causes about 2,000 deaths annually with approximately 48 percent of admitted children being under age five,” he said. 

The Director-General said with malaria being the major cause of hospital attendance, contributing to an estimated 30 percent of admissions in Ghana, it was “something that we can no longer contend with.” 

Hence the need to tap into newly developed tools such as the RTS, S vaccine, and a recombinant protein-based malaria vaccine to help Africa move from control to elimination.     

Dr. Kuma-Aboagye said scaling up the vaccine uptake would protect and avert severe malaria-related illnesses and deaths in children living in highly endemic regions and districts, who were not using any preventive interventions such as the Insecticide Treated Bed Nets (ITN). 

 Evidence from the Pilot implementation in Ghana, Kenya and Malawi over the past three years showed increased confidence in the vaccine as being safe and feasible to be incorporated into the routine immunisation programme, he said. 

He urged the media to support the GHS with continuous advocacy and awareness creation on the devastating effect of malaria, existing interventions, positive behaviors to reduce spread, dispelling rumors and misinformation, and building trust to prevent hesitancy. 

Dr Kwame Amponsa Achiano, the Programme Manager of Expanded Programme for Immunisation (EPI), said the RTS, S Malaria vaccine had, since May 2019, been effectively incorporated into Ghana’s routine immunisation through sustained social mobilisation efforts. 

Approximately 1.4 million doses of the vaccine had been safely administered to children less than two years in Africa as of September 2022, with a recorded improvement in Ghana’s coverage within the selected districts, compared to available data from 2021. 

The Ministry of Health, through the GHS, he said, had provided the vaccine in the pilot districts in phases. 

Apart from the 42 districts in the first Phase, the second and third phases would involve additional 51, and a further expansion to 168 districts respectively, based on the malaria burden, epidemiology and global availability of the vaccines from 2024.   

Dr. Achiano said a substantial drop in hospitalisation and deaths in children under five years was being reported after the introduction of the vaccine in endemic regions.   

However, the RTS, S vaccine was not a substitute for existing preventive interventions, but important additional protection to achieve reduction and elimination of malaria-related illnesses in children, he said. 

“Sleeping under Insecticide Treated bed Nets (ITN) throughout the night is as important as the vaccine itself”.  

 Dr Achiano said progress in reducing malaria globally had stalled, and new tools were needed to get back on track, citing the Annual Malaria Report on Ghana, which showed a high burden of about 5.7 million confirmed cases. 

It also showed 257 deaths in 2021 alone, with children accounting for 28 and 45 percentages, respectively, for morbidity and mortality.   

He spoke about the high-level political support and commitment received across board, improved uptake of vaccine, and the fact that almost all implementing districts had reached at least 60 percent coverage. 

This is despite the initial challenges with the wave of anti-vaccine campaigner against the MVIP. 

 Dr. Achiano said in terms of vaccination coverage, the annual target population of under one year was 175,000, but challenges including health worker education leading to missed opportunities, staff attrition in vaccination areas due to rampant movement, high drop-out rates between the third and fourth doses had also affected the progress. 

He said on-going interventions to address the gaps included; performance meetings with peripheral staff, health worker engagements, provision of tool guides on key messages, and refresher training. 

Others are; targeted support to overcome defaulters, home visits, mop-up activities and community education with the support of all stakeholders.