In an historic?announcement, the World Health Organization (WHO)?today?recommended?widespread immunization of children across sub-Saharan Africa?and elsewhere?with the world’s first vaccine against malaria?to advance beyond pilot and testing phases.?Sub-Saharan Africa is home to more than 90 percent of?malaria deaths worldwide, with many?areas of moderate to high transmission. The recommendation is based on results from an ongoing WHO-coordinated pilot program?of the RTS,S vaccine?in?Ghana, Kenya, and Malawi?that has reached more than 800,000 children since 2019.

“This long-awaited?malaria?vaccine is a breakthrough for science, child health and malaria control,” said WHO Director-General Dr. Tedros?Adhanom Ghebreyesus in today’s press briefing. “Using this vaccine in addition to existing tools to prevent malaria could save tens of thousands of young lives each year.”?RTS,S?has been proven to?significantly reduce life-threatening,?severe malaria?among children?by 30 percent.

To date, the Ministries of Health of Ghana, Kenya, and Malawi have administered 2.3 million RTS,S vaccine doses through this pilot program, showing that routine child immunization services can be used strategically and effectively to deliver the malaria vaccine. The pilot demonstrated the vaccine’s safety and underscored strong community demand.?These findings highlight the potential of adding a vaccine to the?array?of?proven, existing?malaria tools that can be used to fight this disease and accelerate the pace of progress?against malaria across?Africa?and beyond.

“We celebrate the?historic?milestone of the first-ever recommended vaccine for malaria.?This?promising?new tool?to protect?children, who are?most vulnerable?to?malaria,?must complement existing, cost-effective, proven interventions like?mosquito?nets,?indoor residual spraying,?fever testing, and malaria treatment,”?said?Margaret Reilly McDonnell, executive director?of the ’s?Nothing But Nets?campaign.?“Innovations like this, coupled with increased political will,?funding,?and commitment?move?us?closer to?a malaria-free world.”

Malaria preys heavily on vulnerable, marginalized populations, including children under 5, pregnant women, indigenous people, refugees, and displaced individuals. Despite considerable progress with?greater use of?insecticide-treated?bed nets,?indoor?residual?spraying, and the adoption of highly effective treatments, malaria?remains a primary?killer of children?in sub-Saharan Africa.?More than 260,000 African children die from malaria each year.

While malaria deaths have been cut in half since 2000, this recommendation—based on the advice of WHO’s global advisory bodies for immunization and malaria—comes at a time when progress against malaria has stalled or reversed in some areas.

Malaria continues to be both a cause and effect of poverty and inequality. WHO and partners have called for new tools, including malaria vaccines, to help get malaria control efforts back on track, improve child health, and save lives. Layering the malaria?vaccine with other highly effective prevention tools, such as?mosquito?nets,?indoor?residual?spraying,?and?wider community case management?can increase equity in access to malaria prevention and help us reach those that are being left behind.

Data from?Chileka?Health Centre?in Lilongwe, Malawi, where the RTS,S pilot took place, indicates a decrease in hospital admissions for malaria illness among children under 5 since the vaccine was introduced. Health workers say this drop may be due to the malaria vaccine, which has also improved the routine immunization uptake. Before the pilot, most mothers would stop clinic visits when their children got their last jab of measles at 15 months. The malaria vaccine has extended the immunization period to 22 months for the RTS,S fourth dose, allowing growth monitoring and general health checks at these visits, which help detect preventable health threats in?young?children.

Clara Magalasi, who lives in a rural village near Lilongwe, the capital city of Malawi, speaks with a WHO worker. Photo: Hudson Kubwalo/ WHO Malawi

Clara?Magalasi, who lives in a rural village near Lilongwe, the capital city of Malawi, walked four kilometers to?Chileka?Health Center to take her 22-month-old daughter Grace?Butawo?for her fourth and final dose of the?RTS,S?malaria vaccine.??

“I understand that if my child gets all four doses, the vaccine will give her the most protection against malaria and severe malaria. Ever since Grace was born, she has never suffered from malaria, unlike my other children who experienced a lot of malaria episodes when they were the same age as Grace,” said?Clara.

Malaria elimination requires a combination of complementary innovative tools and approaches?tailored to local contexts?to?avoid?a one-size fits all approach. This breakthrough is built on?more than?30 years of research and development?by?technical partners?with?the collaboration of in-country and international partners.

The next step is for countries with high rates of malaria?to?choose to adopt the vaccine as part of their national malaria control programs,?and?for?global health funding bodies to consider?how they might financially support?these efforts.? Both will be key?to reach the last mile of the malaria fight.

 

This blog post also appears on?Nothing But Nets.

Featured Photo: James Oatway/ UNICEF