On 22 January 2024, Cameroon was the first nation in the world to roll out a routine vaccine for malaria. This age-old scourge still kills over 1,600 children in Africa every day, and, until now, a vaccine has never been available. Vaccines are among the most effective public health measures to combat everything from smallpox to COVID. However, they can be oversold. So, how does this malaria vaccine stack up?
The vaccine being rolled out in Cameroon is, at best, 36 percent effective, if correctly administered. During phase 3 clinical trials, the vaccine proved far less effective when given to infants younger than six months. Since timing is so important, the administration of the doses will require significant logistical support. We don’t know how effective the vaccine will be if even one dose is missed or mistimed.
Since powerful interests—from the Gates Foundation and Gavi, the Vaccine Alliance, to the WHO, the World Bank, and UNICEF—are backing the vaccine, the logistical support should be available. But supply is a trickier issue. At the moment, only 18 million doses of the vaccine are likely to be available by the end of 2025 for the twenty or so countries that want to participate in the trials. Production will need to be ramped up. Efficacy will fall well below 36 percent if doses are missed because resources have been spread too thin.
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As we learned during COVID, people react to incentives and will change their behaviour if they think they’re already protected from a disease. Will the vaccinated continue to sleep under bed nets when it is swelteringly hot and humid? If not, then malaria transmission may increase.
