It is now possible to conceptualize in our lifetime the eradication of malaria.
That's because the World Health Organization (WHO) is " of the RTS,S/AS01 (RTS,S) among children in sub-Saharan Africa" and other regions affected by the deadly, mosquito-borne parasite. Ensuring that happens, however, will take as much global coordination as it has to develop the vaccine.
An ongoing program to study the vaccine's efficacy in Ghana, Kenya, and Malawi has reached more than 800,000 children since 2019. When children ages 5 to 17 months old received the over 4 years, it reduced clinical and severe cases of malaria by about a third. It's imperfect but still a success, especially in light of a different, much more grim 2019 milestone: UNICEF globally that led to 409,000 deaths, 67% of which were children under 5 years old.
Even children who survive malaria can experience malnutrition, stunted growth and development, and chronic reinfection. Sub-Saharan Africa's future had begun to disappear as the region shouldered 94% of all the world's malaria cases and deaths.
Still, they've moved forward, even as they've faced other killers, including AIDS, tuberculosis, and COVID-19. They needed another tool to prevent malaria because other preventive measures weren't enough.
"Vector control" methods to fight malaria have people sleeping under insecticide-treated mosquito nets and spraying indoors to kill mosquitoes. But nets become worn and mosquitoes can become resistant to insecticides. For their part, anti-malarial drugs are effective -- when the parasite doesn't become resistant to them, as we're now beginning to see in parts of Africa.
Countries affected by malaria will still need to employ those strategies, but the vaccine may be the most effective way to eliminate this parasite. While this RTS,S vaccine is about in reducing deadly severe malaria, it's hopeful that a second vaccine in clinical trials, showing , will better prevent the disease.
It's promising that the global coordination for this effort among the people and governments of sub-Saharan Africa, U.K.-based researchers, and the WHO has already allowed the vaccine to reach those 800,000 children. It means they can recreate, rather than reinvent, distribution strategies.
However, there are other potential obstacles in the way. Worldwide collaboration will be key in overcoming them.
The malaria parasite could jump to a different, non-human host, making it impossible to eradicate even with the use of a vaccine. There may be supply chain problems, as manufacturers of vaccines, syringes, needles, and storage focus on COVID-19.
Then there's vaccine hesitancy.
Fortunately, the people of the countries most afflicted with malaria tend to be supportive of vaccines. And perhaps it's good news that this vaccine is a "traditional" recombinant protein-based vaccine, as opposed to mRNA-based.
But the super-sized vaccine opposition present in other areas of the world doesn't stop at borders. International public health officials will have to launch a thoughtful, well-timed information campaign.
Developing the malaria vaccine is a dramatic, international victory, and it will take a significant ongoing commitment to overcome some of the logistical and philosophical obstacles associated with it. But if the people of malaria-afflicted countries can progress in the face of the loss they've endured, then the world can't step away from the chance to wipe out this deadly parasite.
is Northwell Health's Director of Global Health and an assistant professor at the Donald and Barbara Zucker School of Medicine at Hofstra/Northwell in New York.