Rain had turned the dirt road into thick mud, but Mabel Djoumessi kept walking with her 9-month-old son, Kenfack, strapped to her back. His malaria vaccination appointment at a clinic in central Cameroon was too important to miss.
For decades, millions of children across Africa have fallen sick from malaria, one of the continent's deadliest diseases for the young. But Kenfack has never had it — a feat his mother attributes to the recent arrival of a malaria vaccine called RTS,S.
"My other children who have never taken the vaccine frequently fall ill," Djoumessi said at Soa District Hospital in Yaoundé.
More than two years after Cameroon became the first country to add the RTS,S vaccine to its routine childhood immunization program, health workers say it is making a real difference. Data from Cameroon's National Malaria Control Program shows that health facilities recorded 33,000 fewer malaria cases in 2025 than in 2024.
Malaria remains the leading cause of hospital visits and admissions in Cameroon, which is one of 11 countries carrying about 70% of the global malaria burden. The country reported an estimated 7.6 million malaria cases and 11,700 deaths in 2024. But early signs suggest those numbers are falling.
"It is accurate to say that the vaccine has contributed to the reduction in cases and deaths," said Dr. Bomba Amougou, head of prevention at Cameroon's National Malaria Control Program. The World Health Organization (WHO) had recommended the RTS,S vaccine for wider use in 2021 after pilot studies in Ghana, Kenya, and Malawi found it reduced deaths among eligible children by 13%. In clinical trials across several African countries, both RTS,S and a newer vaccine called R21 reduced clinical malaria cases by more than 50% during the first year after three doses.
Over 52 million doses have since reached 25 high-risk African countries with support from Gavi, the Vaccine Alliance. But health workers say a troubling pattern has emerged: too few children are returning for the fourth and final shot, which must be given between 22 and 24 months of age.
In the original pilot program across 158 districts in Ghana, Kenya, and Malawi, about 80% of eligible children received the first dose, given around six months of age. But coverage dropped to just 46% for the fourth dose. Health experts say receiving all doses "makes the protection more potent" and is essential for long-lasting immunity.
"When my son turns 2, I will make sure I come for the fourth dose," Djoumessi said. "I don't want him to suffer like the others."
Malaria still kills one child younger than 5 nearly every minute globally, the vast majority in Africa. The fight against the disease is far from over. But for families like Djoumessi's, the vaccine offers something precious: the chance for a healthier start in life.