Malaria: a VaccinesWork guide
This week VaccinesWork is putting malaria front and centre. The ancient parasitic disease still kills 600,000 people a year, but we have a brand-new defence that is already saving lives in the worst-hit countries. Stick around for stories from the vanguard of malaria: vaccination.
- 25 November 2024
- 5 min read
- by Maya Prabhu , James Fulker
We’ve written about mankind’s fight against malaria as a millennia-old war, but the truth is that for most of history, humanity has been mounting a scrappy underdog resistance, taking heavy losses daily.
To give us our due, we’ve built some great defences over the ages: bed-nets, effective malaria therapy drugs, chemoprevention (sometimes served with tonic and a twist); blood-deep, evolved protection like the sickle-cell trait, mosquito-repellent odours and hazes – the list goes on.
We’ve also landed a few game-changing blows. Malaria – Italian for “bad air” – is no longer endemic to Italy; nor to most of the rest of Europe, nor to the USA. That was ground won largely due to the use, in the middle decades of the 20th century, of the chemical DDT, which seemed like a great way forward until the environmental fall-out was properly tallied.
All of that human energy and ingenuity has kept many millions alive. And yet, still, malaria is thought to have been responsible for up to 5% of all human deaths in the 20th century. It still kills 600,000 people each year.
But we now sit at an inflection point. A new weapon against the deadliest form of the parasitic disease is beginning to roll out to the infant populations of the worst-hit countries, and we are starting to see it make a difference. This is very good. It is also, frankly, thrilling.
Developing a safe, effective vaccine against malaria was the work of decades of focused research. Until the malaria jab, we didn’t have a vaccine for any human parasite, a far more complex organism than the bacteria or viruses most of our immunisations shield us from.
The vaccine products we have now offer a more modest level of protection than the bacterial and viral vaccines in our portfolio, but given the vast scale of malaria’s destructive impact, as long as it is used in conjunction with other lifesaving interventions, that still means we can save or improve the lives of hundreds of thousands of children in just the next few years.
What does that kind of impact look like? We already have glimpses. Kenya, Malawi and Ghana were the three countries enrolled in the large-scale pilot project known as the Malaria Vaccine Implementation Programme (MVIP), which means that parts of these three countries have been rolling out the jab since 2019 – longer than anywhere else.
By 2021, routine immunisation specialist from Kenya’s Kakamega county, Pius Wanyama could report, “Before the initiation of malaria vaccine, we had a lot of severe malaria. In fact, you could hardly miss a day having a child convulsing of high fever due to malaria. When vaccines were introduced, we’ve had malaria, but it’s not severe.”
In lakeside, endemic Kisumu county, a mother called Mary-Anne told VaccinesWork in 2023, “Malaria isn’t so big of an issue now, thanks to the vaccine. People here in my area, Nyalenda B, people are so happy because of it.”
In Malawi, Health Surveillance Assistant Laban Mtenje remembered how busy the months of January and February used to be with cases of malaria. “This ain’t happening anymore, at least in the past few years. For example, last month, 12 under-five children were tested for malaria, but none tested positive. This is a sign that the vaccine is working.” Ghana, meantime, has locked sights on elimination.
After a busy year, 16 African countries are now vaccinating children against malaria as part of their childhood routine vaccination programmes. Next year, more will follow. However, to keep this momentum going Gavi, the Vaccine Alliance – which has supported each and every one of these roll-outs – requires funding, urgently.
It is aiming to raise US$ 9 billion for the 2026–2030 period, with a substantial proportion of this funding earmarked for the malaria vaccine. This funding comes with a target – to give 50 million children access over this 5-year period. This is roughly 7% of all the babies expected to be born worldwide – a huge number that could have a huge impact, and mark a major step forward in our ancient fight against this ancient killer.
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Malaria occupies a unique place in human history. Our neolithic ancestors were afflicted by it; the fall of Rome has even been partially attributed to it. During the 20th Century alone, malaria is estimated to accounted for up to 5% of all human deaths. In this context, 30 years is a metaphorical blink of an eye. But for the researchers who have poured more than half of their careers into developing the world’s first vaccine against malaria, it has felt like an eternity.
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