In just two weeks, an impressive 7 million girls have been vaccinated against the human papillomavirus (HPV), a critical step in protecting them from cervical cancer later in life.

Gavi’s commitment to girls’ health

This achievement marks a significant milestone in Nigeria’s fight against cervical cancer.

In October 2023, Gavi partnered with the Nigerian Ministry of Health and Social Welfare, the National Primary Health Care Development Agency, WHO, and UNICEF to introduce the HPV vaccine into the national immunization program.

Building on this success, Gavi further expanded its collaboration with Girl Effect in May 2024 to focus on reaching girls with critical information and ensuring vaccine access.

Protecting a generation from cervical cancer

Cervical cancer is the second most prevalent cancer among women in Nigeria, claiming countless lives each year.

The HPV vaccine offers a highly effective tool for prevention, with an average success rate of 92%. By vaccinating 7 million girls in just two weeks, Nigeria has made significant progress towards its goal of reaching 16 million girls by 2025.

Dr. Sani Nishtar, CEO of Gavi, stated:

“This achievement is a testament to the tremendous collaboration between Gavi, the Nigerian government, and our partners. By prioritising girls’ health, we are empowering a generation and helping to save countless lives.”

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Global impact

Globally, cervical cancer is responsible for over 342,000 deaths annually, with a disproportionate impact on women in low- and middle-income countries.

Ensuring broad access to the HPV vaccine is critical to reducing this devastating disease burden.

This international support of nearly US$160 million from 2022-2025 will facilitate increased vaccine access to children at high risk of illness and death from malaria, starting with Ghana, Kenya and Malawi, the three African countries that began pilot introduction of the vaccine in 2019, and then expanding to other eligible endemic countries.

Malaria remains a primary cause of childhood illness and death in sub-Saharan Africa. In 2020, nearly half a million African children died from malaria – or 1 child died of malaria every minute.

Since the world’s first malaria vaccine was introduced in 2019, it has been well accepted in African communities after a relatively short period of time.

Demand is high even in the context of COVID-19: vaccination performance for the first dose is reaching between 73% to over 90% coverage, depending on the country, with no major disruptions during the pandemic. To date, about 1.3 million children have benefitted from the vaccine in the three African pilot countries.

“Gavi’s new funding opportunity brings us one step closer to reaching millions more children across Africa with the lifesaving RTS,S malaria vaccine,” said Dr Matshidiso Moeti, WHO Regional Director for Africa. “Throughout the pandemic, when routine health services faced myriad challenges, parents and caregivers diligently brought their children to clinics and health posts to get the malaria vaccine. They know all too well that lives are being lost to malaria every day and are eager to protect their children from this deadly disease.”

Following WHO’s recommendation in October 2021 for widespread use of the RTS,S malaria vaccine among children in regions with moderate to high Plasmodium falciparum malaria transmission, a number of malaria-endemic countries have expressed interest in adopting the vaccine and are expected to apply for Gavi support to introduce the vaccine. The RTS,S vaccine works specifically against Plasmodium falciparum, which is the deadliest malaria parasite and the most prevalent on the African continent. Where the vaccine has been introduced, there has been a substantial drop in children being hospitalized with severe malaria and a drop in child deaths in the age group that is eligible for the vaccine.

Gavi has indicated that the first application deadline in September 2022 is reserved for countries currently piloting the vaccine and for which continuity of the vaccine programme is a priority. A second window open to other eligible malaria-endemic countries will close in January 2023. Countries can already submit expressions of interest during the first funding window for inclusion in this round.

“Malaria has devastated communities for far too long in Africa. We know that initially, supply, will not meet demand, nevertheless, we look forward to working with countries and our partners to introduce and scale this new tool in our fight against malaria, which could save the lives of thousands of children across the continent,” said Thabani Maphosa, Managing Director of Country Programmes at Gavi. “Gavi is proud to support this vaccine, and we hope this is just the beginning of a broader rollout that will see populations across the continent increasingly protected against this deadly disease.”

Like with many new vaccines, the supply of the malaria vaccine is limited as vaccine production ramps up.

“The long-awaited malaria vaccine for children is a breakthrough for science, child health and malaria control. It is projected that – at scale – using this vaccine could save tens of thousands of young lives each year, but we will need an increased supply of the vaccine so Africa can reap the benefits of this additional tool for malaria prevention,” said Professor Rose Leke, a malaria disease expert from the University of Yaounde in Cameroon, and co-chair of the expert group that advised WHO on a framework to allocate the currently limited malaria vaccine supply.

Over the next few years, the supply of the RTS,S malaria vaccine will be insufficient to meet the needs of over 25 million children born each year in areas where the vaccine is recommended, according to a WHO-commissioned global market study.

Should a second malaria vaccine complete clinical development successfully and be approved for use, the period of constrained supply could be shorter. The demand is estimated to range from 80 to 100 million doses annually.   

In response to the supply situation, WHO has developed, with expert advice, a framework to guide vaccine allocation decisions at global and country levels that ensures children at highest risk across endemic countries are prioritized to receive the vaccine.

The framework also aims to ensure that childhood vaccination services started in the three pilot countries continue without disruption, until supply fully meets demand.

“Now is the time for African countries and communities to call out their interest – to donors, health leaders and manufacturers – in early access to this vaccine. Lives are at stake, every day,” added Dr Moeti. “This situation underlines once again why expanded local production of vaccines is essential for meeting health needs in Africa. We’ve seen encouraging first steps in that direction in recent months, and we are committed to supporting further efforts to expand vaccine production in Africa.”

WHO, Gavi and partners are working to accelerate RTS,S supply by exploring approaches to increase manufacturing capacity, market-shaping and facilitating the development of other first-generation and next-generation malaria vaccines.

Dr Moeti spoke during a virtual press conference today. She was joined by Mr Maphosa and Professor Leke.

Also on hand from WHO Regional Office for Africa to respond to questions were: Dr Akpaka Kalu, Team Lead, Strategic planning and Policy, Communicable and Noncommunicable diseases Cluster, Dr Opeayo Ogundiran, Epidemiology Pillar Lead for the Regional COVID-19 Response; Dr Phionah Atuhebwe, Medical Officer, New Vaccines and Dr Solomon Woldetsadik, Emergency Response Officer.

The manual healthcare system can cause siloed medical records, limited patient verification, lack of accessibility and offline portability, and results in an inability to aggregate and report data efficiently.

This is why Mastercard, Gavi, the Ethiopia Ministry of Health and JSI have announced a partnership to implement the Mastercard Wellness Pass solution within Ethiopia’s health information system, with the aim of bringing efficiency to healthcare tracking and offline portability of health records in the most marginalized communities.

Mastercard Wellness Pass is an interoperable and offline portable healthcare credential – accessible within a trusted network that creates continuity of care by allowing a patient’s medical data to be stored offline and travel with them on their Mastercard Community Pass chip card, which every patient receives from participating health facilities when they get their first vaccine or health service.

For clinicians, Wellness Pass ensures that the vaccination records are available any time through participating health facilities, regardless of connectivity, and utilizes tokenized biometrics to verify service delivery and adhere to vaccination cycles.

This progressive initiative by the Ministry of Health is just one piece in the larger Information Revolution Agenda, an ambitious component of the Health Sector Transformation Plan that seeks to improve the availability, accessibility, affordability, and quality of primary health care, thereby improving health and wellbeing of the Ethiopian population.

The partnership aims to implement the Wellness Pass technology through several phases. Phase one of the implementation will be focused on Covid-19 vaccination tracking and will be deployed at health facilities throughout the country, including both urban and rural locations, over a 15-month period. Phase two plans to scale the use of Wellness Pass across multiple health care programs, to be determined in partnership with the Ministry of Health.

Creating efficiencies by improving health data accessibility

Mastercard’s Wellness Pass in Ethiopia is the second implementation on the continent, after the launch in Mauritania, which aims to digitize the childhood immunization program to ensure consistent and improved service delivery to parents and children across health facilities and to ensure that government and health partners can access trusted data in an aggregated form to inform policy and decision making.

Gavi, the Vaccine Alliance, and Mastercard have been partnered since 2018, to deploy the Mastercard Wellness Pass to eligible countries, with the aim to not only deliver vaccines to millions of individuals, but also, using Mastercard’s technology, enable digitization of health records in the form of contactless cards.

“Ensuring the equitable distribution of vaccines is critical for the world to emerge from this pandemic, and it will take a collective response by the public and private sector. Working together with Gavi, the Ethiopia Ministry of Health and JSI, this partnership will allow us to bring private sector technology and capabilities to the table to support efforts to make sure that everyone has access to critical health care and that that care is delivered in an efficient and effective manner,” says Michael Froman, Vice Chairman and President of Strategic Growth, Mastercard.

“The digitisation of vaccination records through the Mastercard Wellness Pass enables us to reach and to continue to care for patients with vital health services such as immunisation. Innovative partnerships such as this help us to improve access to care so that everyone receives the essential vaccines they need to survive and thrive,” says Marie-Ange Saraka-Yao, Gavi’s Managing Director of Resource Mobilisation, Private Sector Partnerships & Innovative Finance, Gavi, the Vaccine Alliance

This digital technology will support Ethiopia’s national health response program by enabling the continuity of patient care through the portability of digitized health records. These will be in the form of contactless cards for patients that can be used by health facilities in both connected and offline environments.

The portable health credentials will improve healthcare by decentralizing patient record keeping and facilitating better recording, tracking, and patient adherence to vaccination cycles.

This will benefit not only the patient, but also healthcare service providers, and the Ministry of Health.

“Lack of healthcare data portability has a definite impact on the levels of service utilisation and health outcomes among people in different geographical areas and socio-economic groups. Therefore, it is very important to solve this great challenge, and it will take a collective response by public and private sectors to reach the necessary scale, and this is why we are excited about this new partnership, one that is designed to enable us to provide the best possible care to our citizens, regardless of where they are,” says Dr Lia Tadesse from Ministry of Health.

Digitising health records is the first step to transforming health care across the African continent, but it can be a challenging undertaking for any government. By improving access to and reliability of program data, Ethiopia’s Wellness Pass will allow for more accurate measurement of target populations for COVAX related data-driven planning, improved adherence to health care protocols, and continuity of care to patients through record portability.