What is R21/Matrix-M

What is R21/Matrix-M? 

The World Health Organization (WHO) has recommended the use of the R21/Matrix-M malaria vaccine, co-developed by the University of Oxford and the Serum Institute of India. 

• The Matrix-M component is a proprietary saponin-based adjuvant developed by Novavax and licensed to the Serum Institute for use in endemic countries. 
• As of now, the vaccine has been licensed for use in Ghana, Nigeria and Burkina Faso. 

What is Adjuvant? 

• An adjuvant is an ingredient in a vaccine that enhances the immune system’s response to that vaccine. 
  • Adjuvants help the immune system better recognize what’s in a vaccine and remember it longer, increasing the amount of time that a vaccine may offer protection. 
• Matrix-M adjuvant is derived from saponins, naturally occurring compounds found in the bark of the Quillaja saponaria tree in Chile. Saponins have a history of medicinal use. 

What is Malaria? 

• • About:
    • Malaria is a life-threatening disease caused by the Plasmodium parasite. 
      • This parasite is transmitted to humans through the bites of infected female Anopheles mosquitoes. 
  • Plasmodium Parasite:
    • There are 5 Plasmodium parasite species that cause malaria in humans and 2 of these species, P. falciparum and P. vivax, pose the greatest threat. 
      • P. falciparum is the deadliest malaria parasite and the most prevalent on the African continent. 
      • P. vivax is the dominant malaria parasite in most countries outside sub-Saharan Africa. 
    • The other malaria species which can infect humans are P. malariae, P. ovale and P. knowlesi. 
  • Symptoms:
    • Mild symptoms are fever, chills and headache. Severe symptoms include fatigue, confusion, seizures, and difficulty breathing. 
  • Prevalence:
    • According to the WHO’s World Malaria report 2022, there were 247 million cases of malaria in 2021 compared to 245 million cases in 2020. 
    • It is mostly found in tropical countries. Four African countries accounted for just over half of all malaria deaths worldwide: Nigeria (31.3%), the Democratic Republic of the Congo (12.6%), United Republic of Tanzania (4.1%) and Niger (3.9%) 
  • Vaccine:
    • Along with the recently confirmed R21/Matrix-M vaccine, WHO also recommends broad use of the RTS,S/AS01 malaria vaccine among children living in regions with moderate to high P. falciparum malaria transmission. 
  • Elimination Strategies:
    • Global:
      • The WHO Global Technical Strategy for Malaria 2016–2030, updated in 2021, sets ambitious but achievable global targets, including:
        • reducing malaria case incidence by at least 90% by 2030 
        • reducing malaria mortality rates by at least 90% by 2030 
        • eliminating malaria in at least 35 countries by 2030 
        • preventing a resurgence of malaria in all countries that are malaria-free. 
    • India:
      • National Framework for Malaria Elimination (2016-2030): Based on WHO Global Technical Strategy for Malaria 2016–2030 (GTS), the goals of the NFME are: 
        • Eliminate malaria (zero indigenous cases) throughout the entire country by 2030
        • Maintain malaria–free status in areas where malaria transmission has been interrupted and prevent re-introduction of malaria. 
      • Malaria Elimination Research Alliance-India (MERA-India): 
        • Indian Council of Medical Research (ICMR) has recently established Malaria Elimination Research Alliance-India (MERA-India) which is a conglomeration of partners working on malaria control. 
  • Countries that Eliminated Malaria:
    • Over the last two decades, 11 countries have been certified by the WHO Director-General as malaria-free: United Arab Emirates (2007), Morocco (2010), Turkmenistan (2010), Armenia (2011), Sri Lanka (2016), Kyrgyzstan (2016), Paraguay (2018), Uzbekistan (2018), Algeria (2019), Argentina (2019), and El Salvador (2021). 
      • Countries that have achieved at least 3 consecutive years of zero indigenous cases of malaria are eligible to apply for the WHO certification of malaria elimination. 

• Conclusion 

  • India’s aim is to be malaria-free by 2027 and to eliminate the disease by 2030. Through various measures, the country has made stupendous progress in thwarting malaria, by reducing the disease by 66% between 2018 and 2022.