Freetown, Sierra Leone, 21 August 2017 – The World Health Organization (WHO) is working closely with the Government of Sierra Leone to prevent the spread of infectious diseases such as malaria and cholera in the wake of last week’s mudslides and flooding in Freetown. The Organization is also working with partners to ensure ongoing health care for the injured and displaced, and to provide psychological aid to those coping with trauma.

Around 500 people are known to have died as a result of the flooding and mudslides that devastated whole communities in and around Sierra Leone’s capital, Freetown, and hundreds more are still missing. With thousands displaced and local infrastructure destroyed, WHO has mobilized significant human, technical and financial resources to respond to the emergency.   

“The mudslides have caused extreme suffering and loss of life, and we must do all we can to protect the population from additional health risks,” said Alexander Chimbaru, Officer in Charge of WHO Sierra Leone.

With damage to water and sanitation facilities, residents of affected areas are particularly vulnerable to outbreaks of pre-existing infectious diseases including malaria and diarrheal conditions such as typhoid and cholera. The most recent cholera outbreak in the country occurred in 2012.

WHO is working with health authorities in the country to maximize efforts to prevent and respond to disease outbreaks. Cholera response kits, including rapid testing tools, are being distributed to areas at risk; health and community workers are being trained to recognize the signs of priority diseases, and the Organization is sending additional cholera and emergency kits to the country.

“While the Government and WHO are working hard to strengthen health services in the affected areas, we also urge the population to take the following precautions to help avoid a possible outbreak: hand washing, drinking only water that has been properly boiled or treated, use of latrines for sanitation, and adherence to good food hygiene practices”, added Dr. Chimbaru.

WHO is also providing extensive support in the area of infection prevention and control at health facilities and at the mortuary located at the Connaught Hospital in Freetown, as well as community engagement and psychological first aid.

10 NOVEMBER 2016 | NEW YORK/ATLANTA/GENEVA - Despite a 79% worldwide decrease in measles deaths between 2000 and 2015, nearly 400 children still die from the disease every day, leading health organizations said in a report released today.

"Making measles history is not mission impossible," said Robin Nandy, UNICEF Immunization Chief. "We have the tools and the knowledge to do it; what we lack is the political will to reach every single child, no matter how far. Without this commitment, children will continue to die from a disease that is easy and cheap to prevent."

Mass measles vaccination campaigns and a global increase in routine measles vaccination coverage saved an estimated 20.3 million young lives between 2000 and 2015, according to UNICEF; WHO; Gavi, the Vaccine Alliance; and the Centers for Disease Control and Prevention (CDC).

But progress has been uneven. In 2015, about 20 million infants missed their measles shots and an estimated 134 000 children died from the disease. The Democratic Republic of the Congo, Ethiopia, India, Indonesia, Nigeria and Pakistan account for half of the unvaccinated infants and 75% of the measles deaths.

"It is not acceptable that millions of children miss their vaccines every year. We have a safe and highly effective vaccine to stop the spread of measles and save lives," said Dr. Jean-Marie Okwo-Bele, Director of WHO’s Department of Immunization, Vaccines and Biologicals. "This year, the Region of the Americas was declared free of measles – proof that elimination is possible. Now, we must stop measles in the rest of the world. It starts with vaccination."

"Measles is a key indicator of the strength of a country’s immunization systems and, all too often, it ends up being the canary in the coalmine with outbreaks acting as the first warning of deeper problems," said Dr. Seth Berkley, CEO of Gavi, the Vaccine Alliance. "To address one of the world’s most deadly vaccine-preventable childhood killers we need strong commitments from countries and partners to boost routine immunization coverage and to strengthen surveillance systems."

Measles, a highly contagious viral disease that spreads through direct contact and through the air, is one of the leading causes of death among young children globally. It can be prevented with 2 doses of a safe and effective vaccine.

Measles outbreaks in numerous countries – caused by gaps in routine immunization and in mass vaccination campaigns – continue to be a serious challenge. In 2015, large outbreaks were reported in Egypt, Ethiopia, Germany, Kyrgyzstan and Mongolia. The outbreaks in Germany and Mongolia affected older persons, highlighting the need to vaccinate adolescents and young adults who have no protection against measles.

Measles also tends to flare up in countries in conflict or humanitarian emergencies due to the challenges of vaccinating every child. Last year, outbreaks were reported in Nigeria, Somalia and South Sudan.

Measles elimination in 4 of 6 WHO regions is the global target at the midpoint of the Global Vaccine Action Plan implementation. "The world has missed this target, but we can achieve measles elimination as we have seen in the Region of the Americas," said Dr. Rebecca Martin, director of CDC’s Center for Global Health. "As the African adage goes, ‘it takes a village to raise a child’ and it takes the same local and global villages to protect children against measles. We can eliminate measles from countries and everyone needs to play a role. This year’s report shows that the 2015 WHO regional measles elimination goals were not met because not every child has been reached – gaps exist. We need to close these gaps, ensure that commitments for adequate human and financial resources are kept and used well to reach every child, detect and respond to every case of measles, and prevent further spread. These efforts will protect all children so that they can become the next generation of leaders. This will also ensure that every country has a strong safety net to stop disease threats where they occur and protect the world from global health threats."

Note to editors

The Global Vaccine Action Plan adopted by the World Health Assembly in 2012 set a goal of eliminating measles in 4 regions by 2015. Failure to close immunization coverage gaps has resulted in a failure to meet the goal.

Since 2000, some 1.8 billion children have received measles vaccination through mass measles vaccination campaigns with support from UNICEF, a founding member of the Measles & Rubella Initiative, launched in 2001 with the American Red Cross, the UN Foundation, U.S. Centers for Disease Control and Prevention and the WHO.

Gavi, the Vaccine Alliance, has programmed close to US$1 billion over the period 2016–2020 to help developing countries approach measles in a comprehensive manner that will contribute towards saving more than a million lives.

The latest measles mortality data is published in WHO’s Weekly Epidemiological Report and CDC’s Morbidity and Mortality Weekly Report.

About UNICEF

UNICEF promotes the rights and well-being of every child, in everything the organization does. Together with our partners, we work in 190 countries and territories to translate that commitment into practical action, focusing special effort on reaching the most vulnerable and excluded children, to the benefit of all children, everywhere.

About WHO

WHO is the directing and coordinating authority for health within the United Nations system. It is responsible for providing leadership on global health matters, shaping the health research agenda, setting norms and standards, articulating evidence-based policy options, providing technical support to countries, and monitoring and assessing health trends and improving global health security.

About GAVI, the Vaccine Alliance

Gavi, the Vaccine Alliance is a public-private partnership committed to saving children's lives and protecting people's health by increasing equitable use of vaccines in lower-income countries. The Vaccine Alliance brings together developing country and donor governments, WHO, UNICEF, the World Bank, the vaccine industry, technical agencies, civil society, the Bill & Melinda Gates Foundation and other private sector partners. Gavi uses innovative finance mechanisms, including co-financing by recipient countries, to secure sustainable funding and adequate supply of quality vaccines. Since 2000, Gavi has contributed to the immunisation of nearly 580 million children and the prevention of approximately 8 million future deaths.

About Centers for Disease Control and Prevention

Center for Disease Control's Center for Global Health coordinates and manages the agency's resources and expertise to address global challenges such as HIV/AIDS, malaria, emergency and refugee health, non-communicable diseases, injuries, and more.

7 NOVEMBER 2016 | GENEVA - WHO has issued a new series of recommendations to improve quality of antenatal care in order to reduce the risk of stillbirths and pregnancy complications and give women a positive pregnancy experience.

Last year, an estimated 303 000 women died from pregnancy-related causes, 2.7 million babies died during the first 28 days of life and 2.6 million babies were stillborn. Quality health care during pregnancy and childbirth can prevent many of these deaths, yet globally only 64% of women receive antenatal (prenatal) care four or more times throughout their pregnancy.

Antenatal care is a critical opportunity for health providers to deliver care, support and information to pregnant women. This includes promoting a healthy lifestyle, including good nutrition; detecting and preventing diseases; providing family planning counselling and supporting women who may be experiencing intimate partner violence.

"If women are to use antenatal care services and come back when it is time to have their baby, they must receive good quality care throughout their pregnancy," says Dr Ian Askew, Director of Reproductive Health and Research, WHO. "Pregnancy should be a positive experience for all women and they should receive care that respects their dignity."

WHO recommendations on antenatal care

WHO’s new antenatal care model increases the number of contacts a pregnant woman has with health providers throughout her pregnancy from four to eight. Recent evidence indicates that a higher frequency of antenatal contacts by women and adolescent girls with the health system is associated with a reduced likelihood of stillbirths. This is because of the increased opportunities to detect and manage potential problems. A minimum of eight contacts for antenatal care can reduce perinatal deaths by up to 8 per 1000 births when compared to a minimum of four visits.

The new model increases maternal and fetal assessments to detect problems, improves communication between health providers and pregnant women, and increases the likelihood of positive pregnancy outcomes. It recommends pregnant women to have their first contact in the first 12 weeks’ gestation, with subsequent contacts taking place at 20, 26, 30, 34, 36, 38 and 40 weeks’ gestation.

"More and better quality contacts between all women and their health providers throughout pregnancy will facilitate the uptake of preventive measures, timely detection of risks, reduces complications and addresses health inequalities," says Dr Anthony Costello, Director of Maternal, Newborn, Child and Adolescent Health, WHO. "Antenatal care for first time mothers is key. This will determine how they use antenatal care in future pregnancies."

The new guidelines contain 49 recommendations that outline what care pregnant women should receive at each of the contacts with the health system, including counselling on healthy diet and optimal nutrition, physical activity, tobacco and substance use; malaria and HIV prevention; blood tests and tetanus vaccination; fetal measurements including use of ultrasound; and advice for dealing with common physiological symptoms such as nausea, back pain and constipation.

"Counselling about healthy eating, optimal nutrition and what vitamins or minerals women should take during pregnancy can go a long way in helping them and their developing babies stay healthy throughout pregnancy and beyond," says Dr Francesco Branca, Director Department on Nutrition for Health and Development, WHO.

By recommending an increase in the amount of contact a pregnant woman has with her health provider, WHO is seeking to improve the quality of antenatal care and reduce maternal and perinatal mortality among all populations, including adolescent girls and those in hard-to-reach areas or conflict settings.

WHO recommendations allow flexibility for countries to employ different options for the delivery of antenatal care based on their specific needs. This means, for example, care can be provided through midwives or other trained health personnel, delivered at health facilities or through community outreach services. A woman’s ‘contact’ with her antenatal care provider should be more than a simple ‘visit’ but rather the provision of care and support throughout pregnancy.

Sample recommendations include:

• Antenatal care model with a minimum of eight contacts recommended to reduce perinatal mortality and improve women’s experience of care.
• Counselling about healthy eating and keeping physically active during pregnancy.
• Daily oral iron and folic acid supplementation with 30 mg to 60 mg of elemental iron and 400 µg (0.4 mg) folic acid for pregnant women to prevent maternal anaemia, puerperal sepsis, low birth weight, and preterm birth.
• Tetanus toxoid vaccination is recommended for all pregnant women, depending on previous tetanus vaccination exposure, to prevent neonatal mortality from tetanus.
• One ultrasound scan before 24 weeks’ gestation (early ultrasound) is recommended for pregnant women to estimate gestational age, improve detection of fetal anomalies and multiple pregnancies, reduce induction of labour for post-term pregnancy, and improve a woman’s pregnancy experience.
• Health-care providers should ask all pregnant women about their use of alcohol and other substances (past and present) as early as possible in the pregnancy and at every antenatal visit.

Note to editors

Strengthening health systems, including through improved access to qualified health providers, will be key if countries are to implement the guidelines. In September, the UN Commission on Health Employment and Economic Growth recently called for accelerated investment in the health workforce. In response to the Commission’s request, the Vice-Chairs of the Commission from WHO, the International Labour Organization (ILO), and the Organizations for Economic Cooperation and Development (OECD) will convene all relevant stakeholders by the end of 2016 to develop a 5-year implementation plan for the 10 recommendations

UN, international health and development agencies to promote environmentally and socially responsible procurement of health commodities

7 DECEMBER 2016 | GENEVA - WHO today joined other international agencies in signing a Statement of Intent to align and “green” procurement of health commodities, in an effort to protect the environment and contribute to sustainable development.

“We need to make sure that when international organizations procure health commodities, we promote responsible consumption and production patterns and support the Sustainable Development Goals,” says WHO Director-General Dr Margaret Chan in signing the joint statement at WHO Headquarters in Geneva.

WHO and its sister UN agencies collectively procure an estimated $3 billion in health commodities each year. UN agencies procure significant amounts of generic anti-retroviral therapies (ARTs), anti-Malaria drugs and insecticide-impregnated bed nets, anti-TB medicines and condoms as well as certain vaccines. Additional health commodities procured include medical and laboratory equipment and consumables.

The new agreement sends an important message to suppliers and manufacturers of health commodities that purchasers will increasingly be looking for environmentally and socially sourced health commodities, particularly those within the international health development sector.

WHO and the other signatories have agreed to reflect this common commitment to advancing environmental and socially responsible procurement as part of their standard engagement with suppliers and manufactures. They will also include it in their institutional strategies and policies.

Global Fund Executive-Director Dr Mark Dybul, Ms Aurélia Nguyen, Director of Policy and Market Shaping at GAVI, Mr Jan Dusik, Head of UN Environment in Europe, Ms Maria Luisa Silva, Director of the UNDP office in Geneva, and Ms Marilena Viviani, Director of UNICEF’s Geneva Liaison Office, were also present at the signing ceremony today at WHO Headquarters. Other signatory organizations are UNITAID, UNFPA and UNOPS.

29 NOVEMBER 2016 | GENEVA - In advance of World AIDS Day, WHO has released new guidelines on HIV self-testing to improve access to and uptake of HIV diagnosis.

According to a new WHO progress report lack of an HIV diagnosis is a major obstacle to implementing the Organization’s recommendation that everyone with HIV should be offered antiretroviral therapy (ART).

The report reveals that more than 18 million people with HIV are currently taking ART, and a similar number is still unable to access treatment, the majority of which are unaware of their HIV positive status. Today, 40% of all people with HIV (over 14 million) remain unaware of their status. Many of these are people at higher risk of HIV infection who often find it difficult to access existing testing services.

"Millions of people with HIV are still missing out on life-saving treatment, which can also prevent HIV transmission to others," said Dr Margaret Chan, WHO Director-General. "HIV self-testing should open the door for many more people to know their HIV status and find out how to get treatment and access prevention services."

HIV self-testing means people can use oral fluid or blood- finger-pricks to discover their status in a private and convenient setting. Results are ready within 20 minutes or less. Those with positive results are advised to seek confirmatory tests at health clinics. WHO recommends they receive information and links to counselling as well as rapid referral to prevention, treatment and care services.

HIV self-testing is a way to reach more people with undiagnosed HIV and represents a step forward to empower individuals, diagnose people earlier before they become sick, bring services closer to where people live, and create demand for HIV testing. This is particularly important for those people facing barriers to accessing existing services.

Between 2005 and 2015 the proportion of people with HIV learning of their status increased from 12% to 60% globally. This increase in HIV testing uptake worldwide has led to more than 80% of all people diagnosed with HIV receiving ART.

Who misses out on HIV testing?

HIV testing coverage remains low among various population groups. For example, global coverage rates for all HIV testing, prevention, and treatment are lower among men than women.

Men account for only 30% of people who have tested for HIV. As a result, men with HIV are less likely to be diagnosed and put on antiretroviral treatment and are more likely to die of HIV-related causes than women.

But some women miss out too. Adolescent girls and young women in East and Southern Africa experience infection rates up to eight times higher than among their male peers. Fewer than one in every five girls (15–19 years of age) are aware of their HIV status.

Testing also remains low among "key populations" and their partners - particularly men who have sex with men, sex workers, transgender people, people who inject drugs, and people in prisons - who comprise approximately 44% of the 1.9 million new adult HIV infections that occur each year.

Up to 70 % of partners of people with HIV are also HIV positive. Many of those partners are not currently getting tested. The new WHO guidelines recommend ways to help HIV positive people notify their partners about their status, and also encourage them to get tested.

"By offering HIV self-testing, we can empower people to find out their own HIV status and also to notify their partners and encourage them to get tested as well," said Dr Gottfried Hirnschall, Director of WHO’s Department of HIV. "This should lead to more people knowing their status and being able to act upon it. Self-testing will be particularly relevant for those people who may find it difficult to access testing in clinical settings and might prefer self-testing as their method of choice."

Self-testing has been shown to nearly double the frequency of HIV testing among men who have sex with men, and recent studies in Kenya found that male partners of pregnant women had twice the uptake of HIV testing when offered self-testing compared with standard testing.

Twenty three countries currently have national policies that support HIV self-testing. Many other countries are developing policies, but wide-scale implementation of HIV self-testing remains limited. WHO supports free distribution of HIV self-test kits and other approaches that allow self-test kits to be bought at affordable prices. WHO is also working to reduce costs further to increase access. The new guidance aims to help countries scale up implementation.

WHO is supporting three countries in southern Africa which have started large scale implementation of self-testing through the UNITAID-funded STAR project and many more countries are considering this innovative approach to reaching those who are being left behind.

21 NOVEMBER 2016 | SHANGHAI - Leaders from governments and United Nations organizations, city chiefs, and health experts from around the world today made 2 landmark commitments to promote public health and eradicate poverty.

The 9th Global conference on health promotion, co-organized by WHO and the National Health and Family Planning Commission of the People’s Republic of China in Shanghai on 21–24 November, has agreed:

• The Shanghai Declaration on Health Promotion, which commits to make bold political choices for health, stressing the links between health and wellbeing and the United Nations 2030 Agenda for Sustainable Development and its Sustainable Development Goals.
• The Shanghai Healthy Cities Mayors' Consensus, which contains a commitment by more than 100 mayors to advance health through improved management of urban environments.

WHO Director-General Dr Margaret Chan says underpinning these commitments is the need for government action that protects people from health risks, provides access to healthy choices and spreads awareness of how to be and stay healthy.

Dr Chan adds: "Legislative and fiscal measures are among the most effective interventions that governments – national and city – can take to promote the health of their citizens, from tobacco control and taxing sugary drinks to ensuring people can breathe clean air, bike home safely and walk to school or work without fear of violence."

The Declaration

The Declaration highlights the need for people to be able to control their own health – to be in a position to make healthy lifestyle choices. Noting the need for political action across many different sectors and regions, it highlights the role of good governance and health literacy in improving health, as well as the critical role played by city authorities and communities.

Governance-related commitments include protecting health through public policies, strengthening legislation, regulation and taxation of unhealthy commodities and implementing fiscal policies to enable new investments in health and wellbeing. The Declaration also stresses the importance of universal health coverage, and the need to better address cross-border health issues.

Health literacy pledges include the development of national and local strategies to improve citizens’ awareness of how to live healthy lives, and increasing citizens’ ability to control their own health and its determinants by harnessing the power of digital technology. The Declaration also commits to ensure that environments support healthy consumer choices, for example through pricing policies, transparent information and clear labeling.

The Declaration emphasizes the need for healthy urban policies that promote social inclusion, issues that are further strengthened in the Mayors' Consensus.

Mayors' Consensus

Cities are already home to over 50% of the world’s population, and this is expected to increase to two thirds by 2030, making them a particularly important focus. The Mayors’ Consensus listed 10 action areas that municipal leaders attending the Conference will integrate into their cities’ plans to implement the United Nations 2030 Agenda for Sustainable Development. Key areas include addressing pollution, gender-based violence, child development and making cities smoke-free.

The mayors agreed to integrate health as a core consideration in all city policies; to promote community engagement through multiple platforms, including schools, workplaces and modern technology, to advance health; and to reorient municipal health and social services towards equity and universal health coverage.

Editors' note

The Shanghai event marks the 30th anniversary of the first global conference, held in Canada, which delivered the landmark Ottawa Charter for Health Promotion. The Ottawa Charter made clear the need for political commitment, action and investment to address health and equity, and that the health sector alone could not ensure people attain the highest level of health.

More than 1000 people are participating in the Shanghai Conference, including the Prime Minister of China, more than 40 ministers of health and other sectors, heads of five United Nations agencies and over 100 city mayors. Hundreds of international health experts are also taking part in events dealing with a diverse array of subjects.

17 NOVEMBER 2016 | GENEVA - The world’s first malaria vaccine will be rolled out in pilot projects in sub-Saharan Africa, WHO confirmed today. Funding is now secured for the initial phase of the programme and vaccinations are due to begin in 2018.

The vaccine, known as RTS,S, acts against P. falciparum, the most deadly malaria parasite globally, and the most prevalent in Africa. Advanced clinical trials have shown RTS,S to provide partial protection against malaria in young children.

“The pilot deployment of this first-generation vaccine marks a milestone in the fight against malaria,” said Dr Pedro Alonso, Director of the WHO Global Malaria Programme. “These pilot projects will provide the evidence we need from real-life settings to make informed decisions on whether to deploy the vaccine on a wide scale.”

Vaccine financing and development

The Global Fund to Fight AIDS, Tuberculosis and Malaria today approved US$ 15 million for the malaria vaccine pilots, assuring full funding for the first phase of the programme. Earlier this year, Gavi, the Vaccine Alliance and UNITAID announced commitments of up to US$ 27.5 million and US$ 9.6 million, respectively, for the first 4 years of the vaccine programme.

RTS,S was developed through a partnership between GlaxoSmithKline and the PATH Malaria Vaccine Initiative (MVI), with support from the Bill & Melinda Gates Foundation and from a network of African research centres.

“WHO recognizes and commends the leadership and support of all funding agencies and partners who have made this achievement possible,” said Dr Jean-Marie Okwo-Bele, Director of the WHO Department of Immunization, Vaccines and Biologicals.

Vaccine programme recommended by two WHO advisory bodies

In October 2015, two independent WHO advisory groups comprised of the world’s foremost experts on vaccines and malaria – the Strategic Advisory Group of Experts (SAGE) on Immunization and the Malaria Policy Advisory Committee (MPAC) – recommended pilot implementation of the RTS,S vaccine in 3 to 5 settings in sub-Saharan Africa. These recommendations followed a July 2015 announcement that the European Medicines Agency (EMA) had issued a positive scientific opinion of the RTS,S vaccine.

WHO officially adopted the SAGE-MPAC recommendations in January 2016 and has since worked to mobilize financial support for the pilots and to finalize the programme design. The pilot programme will evaluate the feasibility of delivering the required 4 doses of RTS,S; the impact of RTS,S on lives saved; and the safety of the vaccine in the context of routine use.* It will also assess the extent to which the vaccine’s protective effect demonstrated in children aged 5–17 months old in the Phase 3 trial can be replicated in real-life settings.

Country selection

RTS,S is the first malaria vaccine to successfully complete pivotal Phase 3 testing. The Phase 3 trial enrolled more than 15,000 infants and young children in 7 countries in sub-Saharan Africa. Countries that participated in the Phase 3 clinical trials will be prioritized for inclusion in the WHO pilot programme. Consultations are ongoing and the names of the 3 selected countries will be announced in the coming weeks.

A complementary control tool

The RTS,S vaccine is proposed as a tool to complement the existing package of WHO-recommended malaria preventive, diagnostic and treatment measures and will be used in combination with the current interventions. Other tools include: long-lasting insecticidal bed-nets, spraying inside walls of dwellings with insecticides, preventive treatment for infants and during pregnancy, prompt diagnostic testing, and treatment of confirmed cases with effective anti-malarial medicines.

Deployment of these tools has already dramatically lowered malaria disease burden in many African settings. Between 2000 and 2015, the rate of new malaria cases in sub-Saharan Africa fell by 42% and malaria mortality rates fell by 66%. However, this region continues to account for approximately 90% of global malaria cases and deaths.

As RTS,S is only partially effective, it will be essential that any vaccinated patients with a fever be tested for malaria, and that all those with a confirmed malaria diagnosis are treated with high quality, effective anti-malarial medicines.

Partner quotes:

Dr Seth Berkley, CEO of Gavi, the Vaccine Alliance:

“These pilots are critical to determine whether this vaccine can be rolled out more broadly, adding an important new tool to the proven interventions we already have in the fight against malaria. The Global Fund's commitment marks the beginning of a historic partnership between Gavi, the Global Fund and UNITAID, bringing together three of the world's biggest health financing institutions to tackle one of the leading killers of children."

Mark Dybul, Executive Director of the Global Fund:

“The new vaccine is a potentially valuable new tool in the fight against malaria. With the pilots funded, we are eager to see how this vaccine works in combination with insecticide-treated nets and indoor spraying.”

Lelio Marmora, Executive Director of UNITAID:

"Ending malaria, a disease that kills a disproportionate number of children, is going to require a high degree of ingenuity and boldness. We must seize the opportunity to pilot a vaccine that could strengthen the means at our disposal to combat this deadly disease."

Note to the editors:

There were 2 target age groups in the Phase 3 RTS,S trials:

• Infants who received the malaria vaccine together with other routine childhood vaccines at 6, 10 and 14 weeks of age.
• Older children who received their first dose of the malaria vaccine between 5 and 17 months of age.

Among children in the older age group, there was a risk of febrile seizures within 7 days after any of the vaccine doses. Among infants, this risk was only apparent after the fourth dose. There were no long-lasting consequences due to any of the febrile seizures.

Among children in the older age group, an increase in the number of cases of meningitis and cerebral malaria was found in the group receiving the malaria vaccine compared to the control group. The significance of these findings in relation to the vaccination is unclear. An excess of meningitis and cerebral malaria was not seen in infants aged 6–12 weeks.