Kenya + 2 more

Malaria vaccines in the making, RTS,S leads

By Simon Kariuki

More than 30 malaria vaccine candidates are at various stages of development. The RTS,S vaccine is at the most advanced stage.

The World Health Organisation has recommended the introduction of the vaccine in Ghana, Kenya and Malawi as a pilot programme to assess its suitability in expanded immunisation programmes.

The vaccine could prove to be a powerful tool in sustaining the gains made over the past decade in reducing malaria-related cases and deaths.

Between 2000 and 2015, new malaria cases fell by 37 per cent globally, and by 42 per cent in Africa. This has been achieved through key interventions such as using treated bednets, spraying houses with insecticides and use of effective antimalarial drugs.

Combined with existing malaria interventions, the vaccine would have the potential to save tens of thousands of lives in Africa. It is important for two other reasons too: First, it would reduce the cost of managing malaria.

Historically, vaccines are more cost-effective in preventing the spread of diseases compared with other methods. Second, the vaccine could end the problem of resistance to both drugs and insecticides that is on the rise.


Ghana, Kenya, and Malawi were selected based on a number of factors. They have high coverage of long-lasting insecticidal nets, well-functioning malaria and immunisation programmes, a high malaria burden and have taken part in an earlier phase of the vaccine trial.

The piloting of the malaria vaccine in the three countries is a major milestone in vaccine research as it will pave the way for the next steps in making decisions about whether it will be widely deployed elsewhere.

The vaccine is meant to complement rather than replace existing malaria interventions.

But there is a growing threat of malaria parasites becoming resistant to antimalarial drugs, and mosquitoes developing resistance to insecticides used in bednets and indoor residual spraying.

Once it is licensed, the vaccine will be a vital new intervention that can help mitigate these developments. The next steps will involve regulatory authorities reviewing the results and making recommendations for wide deployment.

The RTS,S vaccine is a first generation malaria vaccine. This means there is still room to improve its capability to protect against malaria.

But it won’t be a silver bullet, which is why other studies into new drugs and interventions are important.