Cost of introducing and delivering malaria vaccine (RTS,S/AS01E) in areas of seasonal malaria transmission, Mali and Burkina Faso

Halimatou Diawara; Fadima Yaya Bocoum; Alassane Dicko; Ann Levin; Cynthia Lee; Fatoumata Koita; Jean Bosco Ouédraogo; Rosemonde Guissou; Seydou Yabré; Seydou Traoré; Winthrop Morgan; Clint Pecenka; Ranju Baral

doi:10.1136/bmjgh-2022-011316

Cost of introducing and delivering malaria vaccine (RTS,S/AS01_E) in areas of seasonal malaria transmission, Mali and Burkina Faso

BMJ Glob Health. 2023 Apr;8(4):e011316. doi: 10.1136/bmjgh-2022-011316.

Authors

Affiliations

¹ Malaria Research and Training Centre, University of Science Techniques and Technologies of Bamako, Bamako, Mali.
² Chercheur en sciences sociales, Institut de Recherche en Sciences de la Santé, Ouagadougou, Burkina Faso.
³ Levin & Morgan LLC, Bethesda, Maryland, USA.
⁴ PATH, Seattle, Washington DC, USA.
⁵ Institut de Recherche en Sciences do la Sante, Bobo-Dioulasso, Burkina Faso.
⁶ Université Thomas Sankara, Saaba, Burkina Faso.
⁷ PATH, Seattle, Washington DC, USA rbaral@path.org.

^# Contributed equally.

Abstract

Background: The WHO recommends use of the RTS,S/AS01_E (RTS,S) malaria vaccine for young children living in areas of moderate to high Plasmodium falciparum malaria transmission and suggests countries consider seasonal vaccination in areas with highly seasonal malaria. Seasonal vaccination is uncommon and may require adaptations with potential cost consequences. This study prospectively estimates cost of seasonal malaria vaccine delivery in Mali and Burkina Faso.

Methods: Three scenarios for seasonal vaccine delivery are costed (1) mass campaign only, (2) routine Expanded Programme on Immunisation (EPI) and (3) mixed delivery (mass campaign and routine EPI)), from the government's perspective. Resource use data are informed by previous new vaccine introductions, supplemented with primary data from a sample of health facilities and administrative units.

Findings: At an assumed vaccine price of US $5 per dose, the economic cost per dose administered ranges between $7.73 and $8.68 (mass campaign), $7.04 and $7.38 (routine EPI) and $7.26 and $7.93 (mixed delivery). Excluding commodities, the cost ranges between $1.17 and $2.12 (mass campaign), $0.48 and $0.82 (routine EPI) and $0.70 and $1.37 (mixed delivery). The financial non-commodity cost per dose administered ranges between $0.99 and $1.99 (mass campaign), $0.39 and $0.76 (routine EPI) and $0.58 and $1.28 (mixed delivery). Excluding commodity costs, service delivery is the main cost driver under the mass campaign scenario, accounting for 36% to 55% of the financial cost. Service delivery accounts for 2%-8% and 12%-23% of the total financial cost under routine EPI and mixed delivery scenarios, respectively.

Conclusion: Vaccine delivery using the mass campaign approach is most costly followed by mixed delivery and routine EPI delivery approaches, in both countries. Our cost estimates provide useful insights for decisions regarding delivery approaches, as countries plan the malaria vaccine rollout.

Keywords: malaria; vaccines.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Burkina Faso
Child
Child, Preschool
Humans
Malaria Vaccines*
Malaria* / prevention & control
Mali
Seasons

Substances

Malaria Vaccines