Faster protection of African children from malaria

“As a malaria researcher, I used to dream of the day we would have a safe and effective vaccine against malaria. Now we have two,” says Dr Tedros Adhanom Ghebreyesus, Director-General of the World Health Organization.

WHO just recommended a new vaccine, R21/Matrix-M, for the prevention of malaria in children. The first malaria vaccine recommended by WHO was the RTS,S/AS01 vaccine, in 2021. However, as demand for the RTS,S vaccine far exceeds supply, “this second vaccine is a vital additional tool to protect more children faster, and to bring us closer to our vision of a malaria-free future,” the WHO director said.

RTS,S or Mosquirix, has been given to 1.8 million children in Ghana, Malawi, and Kenya and doses are expected to arrive in nine more African countries by year end, Science reports. But the 18 million doses of Mosquirix expected to be available between now and 2025 “are only about 10% of what we need” to protect the estimated 40 million children born every year in malaria-affected areas, says Matthew Laurens, a malaria vaccine expert at the University of Maryland School of Medicine.

R21, which was developed at the University of Oxford in the UK, could soon be available in much larger quantities as the Serum Institute of India (SII), one of the world’s biggest vaccinemakers, says it can produce more than 100 million doses per year, Science reports.

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Three countries—Nigeria, Ghana, and Burkina Faso—had already approved R21 for use based on earlier data. 

Both vaccines have been shown to be safe and effective in preventing malaria in children and, when implemented broadly, are expected to have high public health impact. Malaria, a mosquito-borne disease, places a particularly high burden on children in the African Region, where nearly half a million children die from the disease each year.

Dr Matshidiso Moeti, WHO Regional Director for Africa, emphasized the importance of this recommendation for the continent, saying: “This second vaccine holds real potential to close the huge demand-and-supply gap. Delivered to scale and rolled out widely, the two vaccines can help bolster malaria prevention and control efforts and save hundreds of thousands of young lives in Africa from this deadly disease.”

At least 28 countries in Africa plan to introduce a WHO-recommended malaria vaccine as part of their national immunization programmes. Gavi, the Vaccine Alliance has approved providing technical and financial support to roll out malaria vaccines to 18 countries. The RTS,S vaccine will be rolled out in some African countries in early 2024, and the R21 malaria vaccine is expected to become available to countries mid-2024, WHO says.


WHO recommends R21/Matrix-M vaccine for malaria prevention in updated advice on immunization World Health Organization, Oct. 2, 2023

Promising malaria vaccine clears clinical hurdle, could get WHO endorsement next week. Science, Sep. 29, 2023

Cover image: University of Oxford