This month UNICEF and Gavi announced that 12 African countries would receive 18m doses of Mosquirix, the world’s first malaria vaccine
and Gavi, an organisation promoting vaccination, announced that 12 African countries would receive 18m doses of the world’s first malaria vaccine. Mosquirix, developed by, a British pharma firm, will be deployed over two years with deliveries starting at the end of 2023. It is expected to save tens of thousands of lives each year, mostly of very young children.
Malaria, a parasitic infection transmitted by mosquitoes, is one of Africa’s deadliest diseases. Although it is treatable, the infection must be identified and the patient attended to quickly. That is difficult in the continent’s many remote rural areas. As a result malaria kills nearly 500,000 children under the age of five every year. Hitherto the best option has been to try to prevent malaria with insecticide-treated nets and antimalarial drugs. But these efforts have been insufficient.
The development of an effective malaria vaccine has been a formidable scientific challenge. Normally, vaccines work by training the immune system to recognise antigens—typically proteins—that are found on the surface of the infectious agent. But targeting such proteins on theparasite that causes malaria has proven difficult. The parasite has a multi-stage life cycle, which presents different antigens at different stages, making it harder to pick the best target.
Between 2019 and 2021 trials in 800,000 children in Ghana, Kenya, and Malawi found that inoculation led to a 30% reduction in severe malaria infections, and a 10% decline in mortality. Shortages of supply mean that the vaccine is for now being allocated to countries where the burden of malaria is heaviest .
Although the vaccine is a milestone in malaria treatment, more work is needed. Mosquirix’s efficacy is relatively low—particularly when compared with the 95% achieved by covid-19 vaccines. But a more effective jab, R21/Matrix-M, is in sight. Small-scale trials suggest it could have an 77% efficacy rate.
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