For the first time in history, a malaria vaccine is being deployed at scale across Africa. Twelve countries are set to receive 18 million doses of the RTS,S/AS01 vaccine between 2023 C.E. and 2025 C.E. — a milestone that could prevent tens of thousands of child deaths every year and reshape the fight against one of the continent’s most lethal diseases.
At a glance
- Malaria vaccine rollout: Nine countries — Benin, Burkina Faso, Burundi, Cameroon, the Democratic Republic of the Congo, Liberia, Niger, Sierra Leone, and Uganda — will introduce the vaccine into routine immunization for the first time, joining Ghana, Kenya, and Malawi.
- RTS,S/AS01 vaccine: More than 1.7 million children in Ghana, Kenya, and Malawi have already received doses since the pilot launched in 2019 C.E., with results showing a substantial reduction in severe malaria cases and a fall in child deaths.
- Child mortality impact: Malaria kills nearly half a million children under age five each year and accounts for roughly 96% of global malaria deaths — the overwhelming majority of them in Africa.
A century in the making
Malaria has resisted vaccine development longer than almost any other infectious disease. The parasite responsible — Plasmodium falciparum — is far more complex than a virus, cycling through multiple life stages and evading the immune system with unusual sophistication.
The RTS,S/AS01 vaccine, developed by GSK over several decades, was the first to clear regulatory review and receive WHO recommendation. It is not perfect — efficacy sits at roughly 30–40% against severe malaria — but in a disease that kills so relentlessly, even partial protection translates into enormous numbers of lives saved when deployed across millions of children.
The allocation framework used to decide which countries receive doses first was developed in 2022 C.E. by WHO, with expert advisors drawn primarily from Africa. It applies an ethics-based principle of solidarity, directing first doses to populations where children face the highest risk of dying. Representatives from the Africa Centres for Disease Control and Prevention, civil society groups, and independent advisors all participated in the process — a deliberate effort to center African expertise and authority in a decision that affects African children most.
What the numbers mean
The scale of malaria’s toll is difficult to absorb. In 2021 C.E. alone, Africa accounted for approximately 95% of global malaria cases and 96% of deaths. Nearly every minute, a child under five dies of the disease.
“Nearly every minute, a child under 5 years old dies of malaria,” said UNICEF Associate Director of Immunization Ephrem T. Lemango. “For a long time, these deaths have been preventable and treatable; but the roll-out of this vaccine will give children, especially in Africa, an even better chance at surviving.”
The first doses are expected to arrive in countries during the final quarter of 2023 C.E., with national rollouts beginning in early 2024 C.E. Annual global demand for malaria vaccines is projected to reach 40–60 million doses by 2026 C.E. and 80–100 million doses per year by 2030 C.E. — numbers that will require a significant ramp-up in manufacturing capacity.
Building toward wider access
The 18 million doses in this allocation represent a meaningful start, but they fall well short of the total need. Gavi, WHO, and UNICEF have acknowledged openly that supply constraints will limit access in the early years. At least 28 African countries have expressed interest in the vaccine, and demand far exceeds current production.
A second vaccine, R21/Matrix-M, developed by Oxford University and manufactured by the Serum Institute of India, was awaiting WHO prequalification as of 2023 C.E. Its approval would add meaningful supply to the pipeline and give countries a second option.
Gavi has published a roadmap to scale supply over the coming years, and manufacturers including Bharat Biotech are expected to produce RTS,S doses in addition to GSK. The public-private coordination behind this effort — involving WHO, UNICEF, the Global Fund, Unitaid, and the Bill & Melinda Gates Foundation — reflects the kind of infrastructure that took decades to build and is now being put to its most ambitious test.
Real results from the pilot
The numbers from Ghana, Kenya, and Malawi offer reason for confidence. Since 2019 C.E., the three pilot countries have seen real declines in severe malaria cases among vaccinated children. Deaths have fallen. Communities have embraced the vaccine with high demand — a sign that families, having watched malaria take children for generations, understand what is at stake.
“The malaria vaccine is a breakthrough to improve child health and child survival; and families and communities, rightly, want this vaccine for their children,” said Dr. Kate O’Brien, WHO Director of Immunization, Vaccines and Biologicals. “We will work tirelessly to increase supply until all children at risk have access.”
The rollout will proceed alongside existing malaria interventions — bed nets, indoor spraying, preventive drug treatments — not instead of them. WHO guidance is clear that the vaccine works best as part of a layered prevention strategy, not as a standalone solution. That honest framing is part of what makes this rollout credible.
Supply remains the central unresolved challenge. The gap between the 18 million doses now allocated and the 80–100 million doses projected to be needed annually by 2030 C.E. is vast. Closing it will require sustained investment, manufacturing partnerships, and the kind of political will that tends to fluctuate. The vaccine exists. Getting it to every child who needs it is the work still ahead.
Read more
For more on this story, see: WHO — 18 million doses of first-ever malaria vaccine allocated to 12 African countries
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