🦟 Malaria vaccine has reduced child mortality by 13% in three African countries

Four years after Ghana, Kenya and Malawi became the first countries in the world to offer the RTS,S malaria vaccine to their children, a major evaluation has confirmed what researchers hoped but few dared to expect: the vaccine is saving young lives on a continental scale. Across 158 study areas spanning all three pilot nations, the vaccine reduced overall child mortality by 13 percent and cut hospitalizations from severe malaria by 22 percent — a finding that researchers say can be attributed squarely to the vaccine itself. The results, published after a rigorous four-year assessment, mark one of the most significant advances in global child health in recent memory. In 2024 alone, an estimated 438,000 children in Africa died of malaria — most of them under the age of five. The new data suggest a meaningful chunk of those deaths are now preventable. The study tracked 1.29 million children who received at least one dose of the vaccine. Just over one million completed the full three-dose course, and 436,527 children received the crucial fourth dose. Perhaps most remarkably, protection held strong even though coverage was imperfect: only 71 percent of children had received three doses by the end of the evaluation period, and just 40 percent had gotten the fourth. The vaccine worked anyway. "There had previously been concerns that the vaccine would need to be given in all four doses to work," the authors noted. "The new results show that this is not the case." Dr. Kate O'Brien at the World Health Organization, a co-author of the evaluation, put it more bluntly: the results are solid evidence that malaria vaccines can change the trajectory of child mortality in Africa. The study design added credibility to the finding. Researchers randomly assigned 79 areas to introduce the vaccine in 2019, while 79 comparable areas served as a comparison group and received it later. A network of more than 26,000 local reporters notified the research team of child deaths, followed by home visits to confirm details. Use of other interventions — insecticide-treated bed nets, routine childhood vaccinations, fever care — remained similar in both groups throughout the study period, which means the reduction in deaths can be credited to the vaccine and not to any shift in other protective measures. Notably, the vaccine did not crowd out other health interventions. Routine immunization rates and bed net usage stayed stable, and children who lacked other protections were just as likely to receive the vaccine, extending malaria protection to families who might otherwise have gone without. The four-dose schedule also created new contact points with the health system, which researchers say can be leveraged to deliver vitamin A, additional vaccines, or bed nets during the same visits. The findings arrive at a moment of momentum. Twenty-five African countries have now added the malaria vaccine to their childhood immunization programs, and many of them carry a higher malaria burden than the pilot nations. According to WHO, the protective effect in those countries is likely to be as large — or larger — than what was observed in Ghana, Kenya and Malawi. The road ahead is still long, but for the first time, the终点 line is visible.