The challenge of making sure everyone receives the malaria vaccine

The malaria vaccine is due to make its debut within five years. The vaccine developed by Glaxo Smith Kline and the Malaria Vaccine Initiative is just beginning its first clinical trials. After development is done, the task will then shift to how government health ministries will successfully distribute the vaccinations.

From the Inter Press Service writers Joshua Kyalimpa and Terna Gyuse talked to health ministry officials in Uganda about their preparations for the new vaccine.

The debut of a first vaccine against malaria, for example, could now be less than five years away – final testing is under way in seven countries.

Yet developing an effective vaccine is only part of the challenge – effectively integrating it into public health will require careful planning and execution.

The recent history of Africa's immunisation programmes - from the re-emergence of polio in West and Central Africa, to the persistence of meningitis and infant pneumonia - is littered with promising solutions that have failed to have the expected impact. Against a background of poverty and conflict, vaccination campaigns have been hampered by weak infrastructure, insufficient staff or funding, and even popular resistance to vaccinations.

Across the continent, there is new attention to the practical requirements of effective immunisation campaigns. Dr Seraphine Adibaku, head of Uganda's malaria control programme, says his country has already started raising popular awareness of the coming availability of a malaria vaccine, with the most recent meeting of officials from the ministry of health and developers of the vaccine and other stake holders held in May.

"We are conscious not to cause excitement because it can lead to undesirable consequences but we have to tell the people that a vaccine could be here sooner than later," says Adibaku.

Uganda is banking on using infrastructure like ware houses and refrigerators from the Uganda National Expanded Program on Immunisation, which is already in place and has been used on previous immunisation programmes, to roll out the malaria vaccine. Adibaku says training will be given to vaccinators on handling the new vaccine with funding from GAVI, all of which shall be in line with the national vaccination policy.

Adibaku has questions about the vaccine: "We do not know yet for how long the vaccine will offer protection. Do you get protection for six months, one year, or for the rest of your life? These are some on the questions not answered yet."

He says for a vaccine to be effective, it should offer a high level of protection - between 80 and 90 percent - provide long-lasting resistance, and be affordable.

On this last point, Adibaku says a vaccine would be a potent new tool, but worries that high costs could leave poor countries like Uganda unable to make it available.