• Otávio Santiago

'Historic moment': Why the WHO endorsed the first malaria vaccine


For millions of people, malaria creates a grim drumbeat of death, heartbreak, and loss: Every seven seconds, someone gets a case of malaria, and every two minutes, the disease claims another victim under the age of five. That’s why public health experts rejoiced yesterday when the World Health Organization made a landmark decision to endorse the first vaccine against malaria.


Years of clinical trials have shown that this vaccine—known as RTS,S/AS01, or Mosquirix—is safe and helps protect against the disease, especially in concert with other malaria-fighting tools. With a 12-month efficacy of 56 percent, RTS,S lacks the eye-popping effectiveness of other modern vaccines. However, the vaccine’s target—the parasite Plasmodium falciparum—is orders of magnitude more complex than a virus.


“We have a number of things in our toolkit to fight malaria, and they’re all used together: bed nets, spraying, chemoprevention,” says Sean Murphy, a malaria vaccine developer at the University of Washington in Seattle. “This vaccine cannot replace all those tools.”

Also, the WHO recommendation doesn’t immediately usher in widespread use of RTS,S. Rather, it marks the beginning of the vaccine’s broader rollout and paves the way for individual African countries to issue their own approvals of the vaccine, with WHO assistance. Scaling up to the necessary tens of millions of annual doses will require billions of dollars of government and philanthropic donations to the international nonprofit GAVI, the Vaccine Alliance, which coordinates the financing of vaccination programs in developing countries.


But assuming the rollout begins soon, the benefits of this vaccine could be transformative at scale. In a study published last November in PLoS Medicine, researchers found that if 30 million doses of RTS,S were efficiently administered each year across subregions of 21 African countries, the vaccine could avert between 2.8 million and 6.8 million malaria cases each year—and save the lives of between 11,000 and 35,000 children under the age of five.

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