An afterthought on early malaria vaccination

E. Ablorh-Odjidja

May 17, 2019

The early malaria vaccination program, currently underway in Ghana, is as bad an idea as fixing Band-Aid on a festering wound; without first treating the underlying condition.

Yet, there is a push for urgency in implementation by the project promoters, while the fundamentals as to why there is malaria prevalence in Ghana is overlooked.

And as usual, there is no lack of zeal in the pursuit and no want of spokesmen to justify this early vaccination mission.

So, Mosquirix, the early malarial vaccine program, has been given green light by our government and the approach for early vaccination is on.

We must notice the haste to execute the program and it should be worrisome.

This haste explains how we normally tackle our unique problems.

Usually, the fundamentals, the drivers of the problem, are left in place to worsen in the haste, while we chase after the novel approach.

That's why sadly in the end, we come up short, with our missions badly unaccomplished.

So here comes Dr. Anthony Nsiah-Asare, Director General of Ghana Health Services, who has supported the Mosquirix project with a statement like, the early vaccine “will reduce the number of children who die from the disease by 40% yearly.”

Next, a Prof. Evelyn Ansah, Head of Malaria Center at University of Health and Allied Sciences, has also been quoted as saying, the vaccine “provides additional protection of 40% to children against severe malaria.”

Thus, she says ”400,000 die of malaria every year and a 40% reduction can be very significant.”

So, 400,000 malaria deaths from Ghana?

Hard to believe, except nowhere in the reasoning of both Dr. Nsiah-Asare and Prof. Ansah are the fundamentals for malaria infestation mentioned.

And nowhere is it mentioned, as Dr. Nii Bonney Andrews would notice later, "that malaria infestation is a civil engineering problem."

Why there are 400,000 deaths by malaria every year is obviously because of the acutely worsening environmental conditions in our communities.

Vaccines cannot clean our environment, nor alter the fundamental condition for mosquito infestation.

That Prof Ansah claims, “all children are protected against 13 deadly childhood diseases, including diphtheria, measles, poliomyelitis...” by vaccines does not negate the fundamental problem of the dirty and unhealthy environment of our communities.

And, that there are workable vaccines in other areas of disease control, as cited by some other authorities, does not make it permissible to maintain the current unhygienic attitude that grows mosquito population in the country.

Dr. Nii Bonney Andrews, a neurosurgeon based in Ghana and Morocco, seems to understand the problem.  That the danger of the failure to tackle the fundamental condition first, before anything else, poses to the early vaccination program itself.

By this, he is pointing to the conditions of our drainage systems, which are choked with debris and waste.

Pools of dirty standing water in gutters, erstwhile streams and lagoons have turned into brews of stench and the verdant breeding grounds for the mosquito that causes malaria.

So why not seek to eradicate the nourishing grounds of the mosquito first, before jumping to the early vaccination drive against malaria, Dr. Andrews asks.

Fact is we have promoted dirty environments in our communities, a condition which is a boon for the mosquito, but one which has proven lethal for humans.

Rather than eradicating filth, we are rushing to dress up the festering problem with the early malaria vaccination program.

And we promote this drive as a boon to child health.

Even in this, Dr, Andrews points out a potential risk: A damage to the condition called "adaptive childhood" immunity, which the early vaccination proposed program may cause.

Is there a misperception about childhood adaptive immunity conditions,  with regard to malaria, that our so called experts fail to note?

This is a question a scientist must answer. But the ethical implications of that question should be open for all.

Dr. Andrews points to a research done on “Malaria Vaccine and Child Mortality,” published on October 31, 2015, which found “a significant increase in mortality of 50%” at the end of the study in a group of early vaccine subjects.

He wonders whether early vaccination might have interrupted the normal development of adaptive immunity in the children exposed to the program and whether the increase in mortality rate found in the above study can be attributed as cause.

And if so, why is the information on the finding of increase in mortality missing in the push for the early vaccination program?

The justifications offered so far, that others have the vaccine program, so Ghana must also have it; that, the project will ameliorate the impact of malaria on kids, as other vaccines have in other areas of disease control, arguably, is a stretch of reasoning but nothing approaching the scientific.

But Dr. Andrews is still willing to give the vaccine project a try.

In a missive, he responds that, “the vaccine may prove useful within the context of other important preventative measures.”

And indeed, the preventative measures must make sense.

It makes sense to bring our energies to bear on the fundamentals that cause the mosquito infestation in our communities first. This, as said Dr. Andrews, is mainly a civil engineering job.

Additionally important also is a civic education aspect of the civil engineering phase.

Instead of wasting precious broadcast media on religious fraudsters, we can help ourselves a bit better by preaching the merits of a cleaner environment for malaria control on our airwaves.

E. Ablorh-Odjidja, Publisher www.ghanadot.com , Washington, DC, May 17, 2019

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