New evidence published in The Lancet confirms that the RTS,S malaria vaccine has significantly reduced child deaths in the first African countries to offer it, according to a press release issued by the World Health Organization (WHO). Over a four-year period, an estimated 1 in 8 child deaths were averted among those eligible to receive the malaria vaccine in Ghana, Kenya, and Malawi. The authors note that positive impact is likely to be as high or higher in other African countries now offering malaria vaccines to young children in areas of high malaria burden. The findings reinforce the urgency of accelerating wider rollout. They also signal that funding, not supply, remains the central obstacle.
The evaluation assessed data generated through the Malaria Vaccine Implementation Programme (MVIP), which examined the outcomes of malaria vaccine introduction in the first three countries from 2019 to 2023. Despite global progress, malaria continues to take a devastating toll on children in Africa. In 2024, an estimated 438,000 African children died from the disease. Tens of thousands of lives could be saved every year through the wide implementation of WHO-recommended malaria vaccines, RTS,S or R21. WHO recommends an integrated approach combining preventive, diagnostic, and treatment strategies.
Today, 25 endemic countries in Africa are offering malaria vaccines as part of childhood immunization programmes and national malaria control plans. More than 10 million children each year are targeted for malaria vaccination across these countries. These countries have a malaria burden that is at least as high or higher than that measured in the areas evaluated. Positive impact is likely to be as great, if not greater, if similar levels of vaccine coverage can be achieved. Current supply of WHO-recommended malaria vaccines can meet the high demand in countries.
The study authors observed that the four-dose malaria vaccine schedule provides opportunities to deliver other childhood vaccines, such as measles or meningitis vaccine, alongside interventions like vitamin A or insecticide-treated nets (ITNs). The evaluation confirmed that malaria vaccine introduction has no negative consequences on uptake of other childhood vaccines or use of ITNs.
“This is very solid evidence of the potential for malaria vaccines to change the trajectory of child mortality in Africa, and why it is urgent to overcome funding challenges to accelerate rollout,” said Dr Kate O’Brien, WHO Director of the Department of Immunization, Vaccines and Biologicals.
She added that demand is high and supply is sufficient, but more financing is needed. A considerable segment of children not using ITNs received the malaria vaccine during the study period.
Funding constraints are preventing many countries from scaling up malaria vaccination to their national targets and sustaining coverage levels already achieved. The authors conclude that the results highlight the urgency of accelerating deployment of malaria vaccines in areas where malaria continues to be a leading cause of child mortality. The evaluation involved scientists and public health specialists from WHO, Africa-based research institutions, and other leading health research institutions. Primary MVIP evaluation partners and co-authors include WHO, Kintampo Health Research Centre in Ghana, Kenya Medical Research Institute-Wellcome Trust in Kenya, Kamuzu University of Health Sciences in Malawi, London School of Hygiene and Tropical Medicine, and U.S. Centers for Disease Control and Prevention. The evidence reinforces malaria vaccination as a key tool in reducing child deaths across Africa.
