Malawi prepares to introduce TCV

Amidst challenges, Malawi delivers for the children

Today is a bright day for the children of Malawi. Starting today, children between the ages of nine months and younger than 15 years are eligible to receive typhoid conjugate vaccine (TCV) in a nationwide campaign seeking to reach 9 million children. After careful consideration and planning, I am proud to say that we have taken an important step to protect our children from typhoid, a potentially deadly disease. For the past several months, Malawi has faced immense public health challenges. We’ve responded to cases of polio and conducted emergency response for cholera. Most recently, we’ve come together to respond to the devastation left in the wake of Cyclone Freddy. Even these enormous challenges could not stop us from bringing TCV into Malawi’s routine immunization system.

We are using the TCV campaign as an opportunity to also reach eligible children with measles-rubella and polio vaccines. Both vaccines are important routine immunizations that have seen reduced coverage during the three years of the COVID-19 pandemic. All eligible children will be offered Vitamin A supplementation as well. This integrated campaign is a testament to the fortitude and perseverance of our health workforce, including the health workers and vaccinators who will go to great lengths to reach millions of Malawian children with vaccines and Vitamin A during the next week.

Typhoid in Malawi

Malawi has long battled a high burden of typhoid; surveillance data show an estimated 444 cases per 100,000 people per year. Children younger than 15 years old bear the highest burden of this disease. Importantly, we are also faced with an incredibly high rate of drug-resistant typhoid; a recent study found that 92% of typhoid samples are multidrug-resistant in Malawi. As we confront difficulties with diagnosis and increasing challenges with accessible and effective antibiotics, we have no time to delay TCV introduction and the protection it will provide.

Climate change poses as increasing threat to our nation and in the southern Africa region, and with it, an increase in waterborne diseases such as typhoid. Cyclone Freddy most recently tore through Malawi; Tropical Storm Ana impacted our country one year ago. As these threats become more pronounced and frequent, TCVs are a crucial and highly effective intervention to keep our children protected against typhoid.

We know TCV in Malawi

TCVs are not new to us; Malawi conducted the first ever TCV efficacy study in Africa. We know firsthand that TCV has an impressive impact against typhoid. Results from the study in our country showed the vaccine is safe and provided 84% protection against typhoid. We begin today’s campaign bolstered by these data, knowing that the impact for our country will be substantial.

A bright future ahead

I am heartened by the vast benefits that TCV introduction will bring the children of Malawi. And I am proud that we are reaching more children with measles-rubella and polio vaccines, further strengthening our routine immunization program. As we make TCV available to all children, we strive for improved health, reduced need for hospital and clinic visits, sustained school and employment opportunities, and children who thrive with reduced risk of disease from typhoid, measles, rubella, and polio. My hope is that all children, families, and communities can strive for their full potential.

After detailed planning, confronting ongoing challenges, and keeping the integrated TCV introduction as our north star, I am grateful to the partners who saw us through an evolving strategy and revisions to our campaign planning. Together, we will take on typhoid. Together, we can create a future that is brighter and healthier for our children.

Photo: A healthcare worker explains how the TCV campaign will be conducted in communities during the launch ceremony. Photo: TyVAC/Madalitso Mvula.