World’s first mass rollout of malaria vaccine begins in Cameroon – with help from UK scientists

The world's first routine malaria vaccination programme has started in Cameroon – with the aim of saving thousands of children's lives per year across Africa.

Around 40 years in the making, the World Health Organization (WHO)-approved RTS,S vaccine, developed by British drugmaker GSK, is designed to work alongside existing tools such as bed nets to combat malaria. The disease kills nearly half a million children under the age of five each year in Africa.

After successful trials, including in Ghana and Kenya, Cameroon is the first country to administer doses through a routine programme, which 19 other countries aim to roll out this year, according to global vaccine alliance Gavi.

There are plans to vaccinate 6.6 million children this year and next across the 20 countries. Africa accounts for 96 per cent of all the world’s deaths from malaria.

“For a long time, we have been waiting for a day like this,” said Mohammed Abdulaziz of the Africa Centres for Disease Control and Prevention (CDC) at a joint online briefing with the WHO, Gavi and other organisations.

Researchers at the Medical Research Council Unit, The Gambia (MRCG), at the London School of Hygiene and Tropical Medicine (LSHTM) have been working alongside local communities and volunteers in Africa for almost three decades to research, develop and deploy the jab.

Professor Umberto D’Alessandro, director of the MRCG, said: “Making the RTS,S vaccine available as a routine vaccination is only possible thanks to decades of work by researchers in Africa working with international partners, with clinical trials at MRCG at LSHTM starting back in 1997.

“The support of volunteers and communities both in The Gambia and the region has been vital in showing that RTS,S, the world’s first malaria vaccine, was safe and could save lives,” he said.

The urgency is clear. Disruptions linked to the Covid-19 pandemic, rising insecticide resistance and other issues have hindered the fight against malaria in recent years with cases rising by around 5 million year-on-year in 2022, according to the WHO. Globally in 2022, there were an estimated 249 million malaria cases and 608,000 malaria deaths in 85 countries. Children under five accounted for about 80 per cent of all malaria deaths in the African region.

Overall, more than 30 countries on the continent have expressed interest in introducing the vaccine. Fears of a supply squeeze have eased since a second vaccine, R21, completed a key regulatory step in December. R21, developed by Oxford University and the Serum Institute of India, was prequalified by the WHO, a crucial step in making the vaccine eligible for global use.

Rolling out the second vaccine “is expected to result in sufficient vaccine supply to meet the high demand and reach millions more children”, the WHO’s director of immunisation, Kate O’Brien, said at the briefing. R21 could be launched in May or June, said Gavi’s chief programme officer, Aurelia Nguyen.

"Having two vaccines for malaria will help to close the huge gap between demand and supply and could save tens of thousands of young lives, especially in Africa," said Tedros Adhanom Ghebreyesus, director-general of the WHO, at a meeting of the UN body's executive board on Monday.

Health experts at the briefing said the rollout was accompanied by extensive community outreach to combat any vaccine hesitancy and to emphasise the importance of continuing to use all established malaria-prevention tools.

The WHO has recommended a schedule of four doses in children from around five months of age, with a fifth dose considered after one year in areas of high risk.