Malaria cases have been on the rise in recent years, with a recorded 249 million cases in 2022, an increase of five million from the previous year. Africa continues to be the most affected region, with 94% of cases and 95% of deaths worldwide. However, there is hope on the horizon with the rollout of two groundbreaking malaria vaccines in 2024.
The first, the RTS,S vaccine, was developed by the Walter Reed Army Research Institute after 30 years of research and was approved by the World Health Organization (WHO) in 2021. This vaccine has shown to prevent 30% of severe malaria cases in children aged 5 and 17 months who received four doses. A recent study published in The Lancet Infectious Diseases in August 2023, showed that giving young children RTS,S alongside other antimalarial prevention treatments before the rainy season reduced malaria by nearly two-thirds.
Since 2019, over 2 million children in Ghana, Kenya and Malawi have been vaccinated with the RTS,S malaria vaccine. In January 2024, Cameroon became the first country to start a routine vaccine programme using RTS,S, offering the vaccine free of charge to all infants up to the age of six months.
A second-generation RTS,S vaccine, the R21/Matrix M, was approved by the WHO in October 2023 and has an impressive 75% efficacy over a year. The Serum Institute of India has already established production capacity for 100 million doses per annum, making it a cost-effective option for malaria-endemic countries in Africa.
While these vaccines are a significant step towards beating malaria, they are not the silver bullet. Malaria elimination strategies such as long-lasting insecticide-treated bed nets, rapid diagnosis, and treatment with an effective antimalarial should still be used in conjunction with these vaccines.
Dr. Jaishree Raman, Principal Medical Scientist and Head of Laboratory for Antimalarial Resistance Monitoring and Malaria Operational Research at the National Institute for Communicable Diseases, said “This will be the year that many vulnerable young African children will have access to not one, but two malaria vaccines.” This is indeed a transformative chapter in Africa’s public health history.
However, there are still challenges to be faced. The demand for the RTS,S vaccine has been unprecedented, and the manufacturer, GlaxoSmithKline, is unable to produce enough doses. The production of the R21/Matrix M vaccine, though simpler, is still subject to WHO approval and prequalification, which has not yet been granted.
Despite these holdups, the rollout of these two vaccines in 2024 is a significant leap towards beating malaria. With the continued implementation of other malaria elimination strategies, the future looks brighter for those at risk of this devastating disease.