First of Its Kind, A New Malaria Vaccine
How USAID support for a groundbreaking new tool promises to be a game changer in sub-Saharan Africa where one child in 13 dies before their fifth birthday
From emperors in ancient Rome to toddlers in sub-Saharan Africa today, people have been dying from malaria for thousands of years. Over the last century, innovative technologies and scientific breakthroughs have supported more than 100 countries, including the United States, to successfully eliminate malaria from within their borders. Yet for more than half the world, malaria remains a leading cause of death and hospitalizations, particularly for young children and pregnant women.
With a child dying from malaria almost every minute, USAID and our partners have worked tirelessly for decades to defeat this devastating disease. Last year, USAID, through the U.S. President’s Malaria Initiative (PMI), helped more than 700 million people by providing cost-effective tools like insecticide-treated bed nets, spraying homes with insecticide, deploying rapid diagnostic tests, and preventing and curing malaria with effective medicines. Still, with more than 240 million malaria cases occurring annually, far too many communities remain at risk of death and economic loss.
Recognizing the need for a new tool in the toolbox, for more than five decades USAID invested in scientific research — more than $125 million in the last 20 years — to help create a powerful piece of technology missing from our arsenal against malaria: a vaccine.
Vaccines are one of our oldest and most effective public health interventions in slowing or stopping the spread of preventable infectious diseases. USAID investments go beyond solely supporting the technology and science of new vaccines. We support the equitable delivery, distribution, and uptake of new and underutilized vaccines, and work to strengthen the routine immunization services that underpin countries’ primary health care systems. From the eradication of smallpox to the delivery of COVID-19 vaccines globally, USAID has always been at the forefront of investing in immunizations to save lives and help communities thrive — including the world’s first malaria vaccine.
An Exciting Breakthrough
Developing a vaccine against malaria proved an incredibly difficult and lengthy process due to the complex life cycle and genetic diversity of the malaria-causing parasite that evades the immune system as it moves from mosquitoes to humans.
But decades of persistence and creativity by the global community to research, develop, and test a malaria vaccine finally paid off. In October 2021, the World Health Organization recommended the world’s first malaria vaccine, called RTS,S/AS01, for widespread use among young children starting at 5 months, who live in areas with moderate to high malaria transmission. RTS,S/AS01 is currently the only vaccine currently recommended by WHO to significantly reduce malaria in young African children, and is also the world’s first vaccine against a parasite, as opposed to a virus or a bacteria.
USAID-funded research played an essential role in identifying the critical protein for this vaccine that has the potential to save tens of thousands of children’s lives each year.
“The world is truly at a turning point in the fight against one of humanity’s oldest and deadliest pandemics,” USAID Administrator Samantha Power said in a statement.
Following this historic announcement, USAID’s long-standing partner, Gavi, the Vaccine Alliance (Gavi), approved funding for a new malaria vaccination program that will support eligible countries in procuring and delivering malaria vaccines to children most at risk. Design for the Gavi malaria vaccine program is still underway, but will eventually assist countries in rolling out vaccines through existing routine immunization platforms. USAID looks forward to partnering with Gavi in this new effort; since 2001, USAID has contributed approximately $2.8 billion to Gavi to help immunize more than 888 million children against a variety of infectious diseases and save more than 15 million lives in low- and middle-income countries.
While the malaria vaccine is a welcome new tool, it is not a magic wand and must be deployed alongside existing malaria interventions for optimal protection. For example, one study found that when the RTS,S/AS01 malaria vaccine was paired with preventive medicine during peak malaria season, hospitalizations and child deaths were reduced by more than 70% than with the vaccine or preventive medicines alone. Pilot implementation showed that the malaria vaccine could reach children without access to a mosquito net, demonstrating that child immunization platforms can improve access for vulnerable children.
The malaria vaccine has the potential to transform child survival for many countries because it can help strengthen and integrate malaria and routine immunization efforts within overall primary health care systems, thereby reaching previously missed children and helping to advance overall health equity.
A Brighter Future
The COVID-19 pandemic has severely disrupted essential services for maternal and child survival, including routine immunization services and malaria prevention activities. As we look ahead to reclaim these disrupted gains and accelerate progress towards our shared goals, intensified efforts are needed to reach and support women and children who are most at risk for acute illness and death. The introduction of the malaria vaccine alongside other lifesaving maternal and child survival interventions could do just that.
“Three years after the start of WHO’s pilot program, more than one million children have been vaccinated with at least their first dose of the new malaria vaccine — a catalytic moment in our progress towards malaria eradication, vaccine development, and global child survival.”
— USAID Assistant Administrator for the Global Health Bureau Dr. Atul Gawande
USAID will continue to invest in malaria vaccine-related research and development, champion equitable access to all vaccines, and support countries to lead in the delivery of essential health services that help give children a healthy start to life and protect communities from preventable infectious diseases.
Because no one should die of a mosquito bite.
About the Authors
Sydney Perlotto is a Knowledge Translation and Communications Specialist within USAID’s Bureau for Global Health. Bridget Higginbotham is a Malaria Technical Advisor for the U.S. President’s Malaria Initiative.
