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Augustine Tamia gently cups her son Philip’s face in her hands and lets out a small sigh.

The love for her only boy is evident but it is clear his health exacts a heavy financial and emotional toll on the family.

The mother-of-four has just returned from a gruelling morning in the cassava fields of rural Ghana.

Earlier this year, she sliced off part of her finger with a machete as she worked to pay off loans used to buy Philip’s malaria medication.

Each bout of the disease takes ten days hard labour to repay and he will fall sick at least three times a year.

Now seven, Philip is already behind at school as he is bedridden for weeks at a time with aches, fever and nausea.

Augustine, 29, was keen for her youngest daughter Rejoice to become part of a pilot vaccine programme fighting the world’s oldest and deadliest disease.

Cradling the inquisitive seven-month-old at their home in Tuobodom Dompoase, Augustine told Metro.co.uk through an interpreter: ‘Since Philip was born, it’s always malaria.

‘Whenever he is ill, it’s malaria.

‘It is difficult to eat if instead I have to pay for medication.

‘I don’t want Rejoice to go through what Philip goes through.

‘I don’t want her to be getting sick day in, day out and being absent from school.

‘I don’t want her to struggle like we do.’

Globally the World Health Organisation recorded 228 million malaria cases and 405,000 premature deaths last year.

Around 90% of those were in sub-Saharan Africa and two-thirds who die are under five.

It is the number one reason why people in Ghana end up in hospital and poor households spend, on average, 34% of their income on treatment.

The country is now one of three taking part in the vaccine programme which, although just 40% effective, has been hailed a ‘game changer’ by experts.

Paediatrician Dr Samuel Harrison from Kintampo hospital, said: ‘Malaria causes a lot of social, economic and medical problems for children, for mothers and for the community as a whole.

‘Unfortunately hospital treatment is often sought very late in many African counties and the cost is very high for poor families.

‘If we are able to prevent 40% of cases of malaria in sub-Saharan Africa then that is huge.

‘We are talking, in terms of numbers, about 80 million children being saved from the deadly implications of malaria.

‘So it’s a very positive thing that is happening.’

Augustine straps Rejoice to her back with a red and white cloth and they set off on foot to the nearby Tuobodom health centre for the vaccine.

Banana and cassava fields line the dusty roads that will become full of stagnant water when the five-month-long rainy season arrives.

These savannahs and forests in central Ghana are the perfect breeding ground for the malarial mosquito, which begin to bite as the sun sets.

Rejoice lets out a little cry as Nurse Irene Asare Danquah slides the needle into her right thigh.

But within minutes, she is happily playing with an empty syringe wrapper while Augustine fills out official forms and promises to return for another dose.

It took three decades of research for scientists at British-firm GSK to develop the vaccine.

Health workers say the vaccine is not meant to replace anti-malarial drugs, residual indoor spraying or insecticide-treated bed nets but, when used alongside, is ‘another tool in the fight.’

Malaria happens when an infected female mosquito bites a person, injecting Plasmodium parasites into the bloodstream.

They pass quickly to the liver, where they mature and multiply before going back into the blood to cause malaria’s debilitating symptoms.

The vaccine – known as RTS,S or Mosquirix – works to stop the parasite entering the liver by encouraging a bitten child’s immune system to make antibodies against it.

The first dose is given when the child is around six months old and a fourth and final booster when they turn two.

The World Health Organisation recommended the pilot programme in selected areas of Ghana, Kenya and Malawi with the aim of vaccinating 360,000 children annually.

Experts say although it is early days, the results are promising despite some initial social media smear campaigns by European-based anti-vaxxers.

GSK donated millions of doses for the programme, which is being funded until 2023 by a number of sources including Gavi (the global vaccine alliance), the Global Fund (of which the UK government is one of the largest donors) and grants from the Bill & Melinda Gates Foundation.

However, additional resources will be needed to bring it to wide-scale use and health officials are concerned particularly in light of coronavirus and the need for a quick vaccine.

Malaria No More UK Chief Executive, James Whiting, said that the pandemic could prove ‘catastrophic’ for places with already weak health services.

He added: ‘It is vital that core malaria prevention and treatment measures continue during the Covid-19 outbreak.

‘If we do not sustain efforts to prevent, detect and treat malaria during this time, we risk reversing the hard-won gains that have been made over many years, compromising the health and well-being of millions of people, particularly those most vulnerable such as pregnant women and children.’

Augustine throws a giggling Rejoice in the air before the youngster is strapped once more to her mother’s back and the pair head for an afternoon in the cassava fields.

Augustine said: ‘I want her to have a higher level of education and I don’t want her to worry like we do.

‘If everyone had the vaccine, we would all be better off and mothers would not have to struggle to pay the medical bills.

‘I feel lucky that we were the ones who were selected for the programme.’

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