—– As Massive Preparation Gets Underway
IPNEWS: Liberia Gears Up to Reduce the Burden of Malaria as She plans to Introduce Malaria Vaccine on April 8, 2024 using the RTSS /R21M/Metrix Vaccine
The Expanded Program on Immunization of the Ministry of Health along with its technical partners converged on October 3, 2023, working session to access the country readiness for the introduction of malaria vaccine into its routine immunization program. Those in attendance were members from EPI, NMCP, USAID, WHO, UNICEF, PMI, FHI 360, Breakthrough Action, LMH, BMGF, FHM Engage, amongst others.
During the meeting, Dr. Adolphus T. Clarke, the EPI Program Manager of Liberia informed the technical partners, staffs and collaborating units of the Ministry of Health on the level of achievement made into the application system of the malaria vaccine, and the readiness tools to show the country preparedness for the introduction of malaria vaccine into the routine immunization program.
According to Dr. Clarke, the National Immunization Technical Advisory Group (NITAG) has been having couple of discussions around the setting up of sites that were selected as per the application for the Malaria Vaccine Introduction.
In speaking he said, “Initially, when we did the application, there were several boundaries that we had to expect, one of such boundaries has to do with stock availability. So, because of stock status, countries were not encouraging to do nationwide, but had to prioritize within based on the burden of the disease. A team of experts that went to Accra, Ghana, being tele-supported from Monrovia were able to reach a decision to do 48 of the 98 health districts, that means, we were intervening in some counties only in one district, in other counties in two districts, and in other counties, in three districts.”
The EPI Program Manager said, fortunately for the program, they were called by the end of December 30, 2023, that there was another Candidate of malaria vaccine that had shown great prospect pending WHO prequalification and that vaccine was the R21M/Matrix. Meanwhile, the R21 vaccine is the second malaria vaccine recommended by WHO, following the RTS, S/AS01 vaccine, which received a WHO recommendation in 2021. Both vaccines are shown to be safe and effective in preventing malaria in children and, when implemented broadly, are expected to have high public health impact.
However, by that news the paradigm shifted. The first thought that came to mind was that, can we look at a new data, and one of such was the malaria indicators survey had just come up in 2022. At the time of the application, the data we referenced was 2016, so we wanted to be sure that our selection was in line with what the data was reflecting or telling us.
The second perimeter was that; we saw in 2022 the national housing population census was conducted which also impacted the population upward. Following this trend, we see that our growth rate increased from 2.1% to 3% so it had 0.9% increase, and took the population from three million, four hundred seventy-six thousand, six hundred eighty (3,476,680) in 2008, to five million, two hundred fifty thousand, one hundred eighty-seven (5,250,187) in 2022. So, we had 1.7 million increases in population which also impacted our target that we had initially planned.
The population have shifted upward, so we had this internal meeting and kept brainstorming on what to do thus bringing the team (EPI, PMI, Malaria control and USAID) to a decision of doing an entire county as supposed to selected district. Dr. Jethro Zarwolo was tasked with an analysis of the situation to see what are the counties that could be considered based on the doses that we have allocated for Liberia, two hundred and thirty thousand (230,000).
In analysis, Dr. Jethro Zarwolo said, we considered the outreach syndrome as it relates to the vaccine, and we also looked at the feasibility of district level introduction verses countywide. The malaria indicators show that the prevalence of malaria has declined significantly as compared to 2016 and the greatest burden remains in the southeastern region.
so, the region designated will be the southeastern region(A) which comprises of Grand Kru, Maryland, and Rivergee and region(B) comprises of Riverces, Sinoe and Grand Gedeh Counties. Base on the quantity of the vaccine that have been allocated, we factor in the wastage rate which happens to be 7%. We also looked at the population growth rate for each of the county, taking the selected counties population into consideration. We also looked at the number of doses that is required to be used for infants in 2024. The 230,000 doses will be able to cover those 6 counties with 25% that could be required for mop-up.
The EPI Program Manager in closing said, the vaccine will be introduced into the program on April 8 of this year 2024, and that parents and caregivers should seize this moment and take advantage of this great opportunity, because our children are our future and hope for the nation. He also said that the vaccine is a two dose vials, made of powder and can be reconstituted. According to him, the vaccine is safe and free, and will be targeting children between the ages of zero to fifty-nine months.
The readiness assessment tools will look at five (5) thematic areas that are subdivided into committees, Planning, training, monitoring & supervision, supply chain and communication.
SEE PICTORIAL AT TECHNICAL MEETING
