Malaria

Triple Billion Targets and Inequalities in Immunization Updated for 2025

Karen McClorey Hackett — Sun, 25 May 2025 17:34:26 +0000

Reviewer:

The World Health Organization (WHO) recently published its World Health Statistics Report 2025, revealing the more profound health impacts on loss of lives, longevity, and overall health and well-being.

As of May 15, 2025, this WHO report presents mixed progress toward the WHO’s Triple Billion targets. An estimated 1.4 billion more people were living healthier by the end of 2024, surpassing the 1 billion target.

The major contributors to the 5.4-year pre-pandemic increase in global healthy life expectancy at birth between 2000 (58.1 years) and 2019 (63.5 years) were mortality reduction from communicable and perinatal conditions among children under 5 years, and from noncommunicable diseases among those 30 years and older.

For example, HIV and TB incidence rates are falling, and fewer people need treatment for neglected tropical diseases.

However, this report stated, 'Increased levels of anxiety and depression linked to the recent pandemic reduced global healthy life expectancy by six weeks, erasing most of the gains made from lower mortality due to noncommunicable diseases during the same period.'

Premature deaths from heart disease, stroke, diabetes, and cancer are rising, driven by population growth and aging, and now account for most deaths among people under the age of 70 worldwide.

The world is currently off track to reduce premature mortality from these diseases by one-third by 2030.

Furthermore, achieving equity in immunization coverage requires focused attention on urban poor areas, remote/ rural areas, conflict areas, and gender-related inequities and barriers.

Dr Samira Asma, WHO Assistant Director-General for Data, Analytics and Delivery for Impact, commented in a media statement, “Together, we can achieve a world where data is timelier and more accurate, programmes improve continuously, and premature deaths become rare."

"Every country can deliver measurable gains with speed, scale, and smart investments.”

Sub Title:

WHO says 1.4 billion more people were living healthier by the end of 2024

Reference:

WHO warns of slowing global health gains in new statistics report 2025

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WHO May 15, 2025

Can Malaria Vaccination Prevent Cancer?

Karen McClorey Hackett — Mon, 05 May 2025 19:29:34 +0000

Reviewer:

Robert Carlson, MD

Researchers may have recently resolved an old mystery of how malaria infection triggers the development of Burkitt lymphoma (BL), the most common childhood cancer in tropical countries in Africa.

BL is a relatively rare cancer globally characterized by elevated enzyme activation-induced cytidine deaminase (AID) levels.

Epstein-Barr virus (EBV) and Plasmodium falciparum malaria are cofactors in the etiology of BL.

Over the years, various theories focused on BL have been proposed and analyzed.

Published in th Journal of Immunology in March 2025, this research tested the hypothesis that P. falciparum and EBV synergize to induce dysregulated AID expression.

A cohort of children from Western Kenya with uncomplicated Malaria and community controls was included, as were children with uncomplicated Malaria who had elevated levels of CD19+ AID+ B cells compared to controls.

This high AID level was sustained up to 8 weeks after parasite clearance.

Using ImageStream flow cytometry, they found that 52% of AID was localized in the nucleus of CD19+ B cells in children with Malaria.

To test whether EBV and P. falciparum synergized to drive the expression of AID, they stimulated CD19+ B cells with EBV, CpG (to mimic P. falciparum DNA), or BAFF (induced during P. falciparum infection), or both.

Individually, EBV, BAFF, and CpG induced AID expression.

However, when combined, there was a significant increase of ∼30% in the frequency of CD19+AID+ cells above cells treated with EBV, BAFF, or CpG individually.

These researchers wrote, 'Collectively, these data suggest that P. falciparum malaria and EBV coinfection result in sustained AID expression, potentially influencing the MYC translocation characteristic of BL.'

A previous study in 2023 suggested that the effects of P. falciparum infections are cumulative, with each additional 100 infections associated with a 39% increase in the risk of developing Burkitt lymphoma.

Therefore, reducing the burden of P. falciparum malaria in young children could help to reduce the burden of this type of cancer.

On World Malaria Day, the World Health Organization (WHO) called for accelerated progress toward eliminating Malaria.

Since the two approved malaria vaccines target the P. falciparum parasite, and are available in Africa in 2025, their introduction could further help decrease Burkitt lymphoma rates in malaria-endemic countries.

As of April 2025, the WHO has certified 45 countries and one territory as malaria-free. Of the remaining 83 malaria-endemic countries, 25 reported fewer than 10 cases of the disease in 2023.

In the United States, most malaria cases are travel-related. However, Florida previously reported locally transmitted malaria cases.

Sub Title:

Malaria vaccines are available in Africa during 2025

References:

Sustained activation induced cytidine deaminase (AID) expression in B cells following Plasmodium falciparum malaria infection

Burkitt lymphoma risk shows geographic and temporal associations with Plasmodium falciparum infections in Uganda, Tanzania, and

Co-infection with Epstein–Barr virus leads to endemic Burkitt lymphoma

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Malaria Remains Endemic in 83 Countries

Karen McClorey Hackett — Mon, 28 Apr 2025 16:26:45 +0000

Reviewer:

Robert Carlson, MD

On World Malaria Day, the World Health Organization (WHO) called for revitalized efforts, from global policy to community action, to accelerate progress toward the elimination of Malaria, a serious disease.

As of April 2025, the WHO has certified 45 countries and one territory as malaria-free. Of the remaining 83 malaria-endemic countries, 25 reported fewer than 10 cases of the disease in 2023.

The WHO says, 'More than 2 billion cases of mosquito-transmitted malaria and nearly 13 million deaths have been prevented since 2000.'

However, as history has shown with diseases such as polio, these gains are fragile.

"The history of malaria teaches us a harsh lesson: when we divert our attention, the disease resurges, taking its greatest toll on the most vulnerable," said WHO Director-General Dr Tedros Adhanom Ghebreyesus, in a media release on April 25, 2025.

"But the same history also shows us what's possible: with strong political commitment, sustained investment, multisectoral action, and community engagement, malaria can be defeated."

The WHO highlighted two positive changes.

The expanded use of a new generation of insecticide-treated nets is poised to lower the disease burden. According to the latest World Malaria Report, these new nets, which have a greater impact against Malaria than the standard pyrethroid-only nets, accounted for nearly 80% of all nets delivered in sub-Saharan Africa in 2023, up from 59% the previous year.

Additionally, the WHO has listed two malaria vaccines and are being administered in various African countries, such as Nigeria.

As of April 28, 2025, the majority of malaria cases in the United States are attributed to travelers returning from Africa, such as in Florida.

However, the Mosquirix and R21/Matrix-M malaria vaccines remain unavailable in the U.S.

In lieu of vaccination, the U.S. CDC says avoiding mosquito bites and taking appropriate medications is the best way to prevent Malaria.

Sub Title:

Malaria Vaccines are available in Africa in April 2025

References:

Strong global collaboration has been critical in saving nearly 13 million lives since 2000

US CDC Yellow Book

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Flying Malaria Vaccines Arrive in Nigeria

Karen McClorey Hackett — Wed, 23 Apr 2025 14:04:03 +0000

Reviewer:

Robert Carlson, MD

Over 20,000 children across the Federal Republic of Nigeria's Bayelsa state recently gained access to malaria vaccines, bypassing traditional distribution routes.

According to an article published by GAVI on April 22, 2025, approved malaria vaccines arrived by Zipline drone, an unmanned mini-plane carrying parachute-equipped cargo in its belly. This innovative technology can drop packages precisely over targeted facilities.

"So far, this initiative has helped to reach 20,000 people with the first dose of the malaria vaccine in the state," said Chinedu Amah, the Sales and Partnership Director for Zipline in Bayelsa state, in GAVI's article.

"Our drones can make the journey in as little as 45 minutes. So it's been a game-changer for the state in its health system, and we've shown a lot of value creation within the state using our drones," Amah added.

According to the World Health Organization (WHO), despite an annual expenditure of $4 billion, malaria deaths and cases have not shown substantial change over the last decade. According to WHO's latest malaria report, there were an estimated 263 million malaria cases and 597,000 related fatalities worldwide in 2023.

This data represents about 11 million more cases than in 2022.

The WHO African Region shoulders the heaviest burden of malaria outbreaks.

Dr Williams of the Bayelsa State Primary Health Care Board told VaccinesWork, "Our (Nigeria) distribution centre, serving hundreds of health facilities and community sites across a 38,000 square-kilometre radius, has drastically reduced stock-outs to below 1%. Deliveries now arrive within 15–45 minutes, regardless of weather or terrain, significantly improving coverage and timeliness."

As of April 23, 2025, the WHO recommends Mosquirix™ and R21 / Matrix-M™ vaccines to prevent this mosquito-transmitted disease for travelers visiting malaria-endemic countries. These malaria vaccines were added to the WHO's list of prequalified vaccines in 2024.

Currently, 17 African countries have introduced malaria vaccines through routine immunization targeting children.

Malaria vaccines are not offered in the United States.

Sub Title:

Malaria Vaccines available in Africa in April 2025

Reference:

Malaria vaccines reach isolated Nigerian communities

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Africa's Unknown Disease Outbreak Remains Undetermined

Donald Hackett — Tue, 04 Mar 2025 16:13:08 +0000

Reviewer:

Robert Carlson, MD

The World Health Organization (WHO) recently published a Situation at a Glance confirming the Democratic Republic of the Congo has reported a cluster of 24 unexplained community deaths in a single village in Ekoto health area, Basankusu health zone, Equateur province.

As of February 25, 2025, a total of 53 deaths have been reported out of 1,318 patients meeting the working suspected case definition.

The WHO's DON557 disclosed on March 3, 2025, that the progression of the unknown disease appeared to be fast, with a median time from the onset of symptoms to death of one day.

The definitive cause of illness remains undetermined, with initial samples testing negative for Ebola and Marburg viruses.

The working hypotheses include chemical poisoning or a cluster of rapid-onset bacterial meningitis, which occur against a background of malaria and other infectious illnesses endemic in the region.

Approximately 50% of malaria tests performed on these cases tested positive for malaria, which is a common mosquito-transmitted disease throughout Africa.

Two malaria vaccines are available in Africa but not in the United States.

As of 2025, the WHO and the European Medicines Agency recommend Mosquirix™ and R21 / Matrix-M™ vaccines for travelers visiting malaria-endemic countries.

With the available information, the WHO has assessed the local public health risk as moderate and the national and global public health risk as low.

The WHO and the U.S. CDC have not issued any travel alerts regarding this event. However, the CDC has included the DRC in numerous travel advisories over the past two years.

Sub Title:

Severe malaria related to the DRC's fatal outbreak in 2025

Reference:

Cluster of community deaths in Basankusu, Equateur- Democratic Republic of the Congo

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WHO DON - Mar. 3, 2025

Blood-stage Malaria Vaccine Booster Complements Approved Vaccines

Karen McClorey Hackett — Sat, 11 Jan 2025 12:20:24 +0000

Reviewer:

Robert Carlson, MD

As two approved malaria vaccines ramp up production to meet demand in 2025, an innovative booster vaccine candidate has been found to enhance immunity and reduce the number of cases and related fatalities.

According to the results of a phase 2b clinical trial, the RH5.1/Matrix-MTM malaria vaccine was 55% effective in preventing clinical malaria over six months.

Unlike the previously approved malaria vaccines (RTS,S/AS01, and R21/Matrix-M) that target the pre-erythrocyte stage, RH5.1/Matrix-M targets blood-stage malaria.

In a Commentary published by The Lancet Infectious Diseases on January 7, 2025, the authors indicated that study participants vaccinated with RH5.1/Matrix-M showed high concentrations of anti-RH5.1 serum IgG antibodies and high levels of in-vitro growth inhibition activity against Plasmodium falciparum.

The vaccine candidate was also well tolerated, with only mild adverse events like fever and injection site swelling.

Moreover, the delayed third-dose regimen induced higher immune responses than the monthly regimen.

"We found this clinical trial finding encouraging for the fight against malaria, particularly in Africa. This blood-stage candidate vaccine RH5.1/Matrix-M will complement the previously WHO-recommended and rolled out pre-erythrocyte malaria vaccines for effective and durable protection, targeting different stages of the parasite life cycle," wrote these authors.

On December 11, 2024, Professor Angela Minassian, an infectious diseases physician and Associate Professor in the Department of Biochemistry who leads the clinical blood-stage malaria vaccine program at the University of Oxford, said in a press release, 'Our goal, by targeting the blood stage of the disease with this vaccine, is to reduce the number of severe cases and deaths significantly.'

"The currently licensed vaccines target the liver stage of the parasite and are very effective at stopping parasites from getting into the blood."

"However, if they fail and parasites slip through the net, the disease will develop as these approved vaccines have no activity against malaria in the blood."

"Adding RH5.1/Matrix-MTM to these licensed vaccines should provide a vital second line of defense, achieving even higher levels of protection. Importantly, our study has provided the first real-world data to show that this type of vaccine works by reducing the level of parasites in the blood.'

This clinical study, which is ongoing in Burkina Faso, has been run by scientists at the University of Oxford in collaboration with the Serum Institute of India Pvt. Ltd, Novavax, and others.

The majority of malaria cases in the United States are travel-related.

As of the week ending November 23, the U.S. CDC confirmed 1,772 malaria cases during 2024, mostly in international travelers arriving in New York City, Miami, Florida, and Los Angeles, California.

While the approved malaria vaccines are offered in various African countries, they are not U.S. FDA-approved and are unavailable at travel clinics and pharmacies in January 2025.

Sub Title:

RH5.1/Matrix-M malaria vaccine candidate enhances immunity

References:

A new RH5.1/Matrix-M candidate malaria vaccine: a promising finding to boost malaria elimination in Africa

First vaccine against blood-stage malaria is well-tolerated and offers effective protection

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Will Malaria Vaccines Defend the USA in 2025

Karen McClorey Hackett — Tue, 07 Jan 2025 10:16:45 +0000

Reviewer:

Robert Carlson, MD

Over the past few years, there has been a very positive trend in reducing mosquito-transmitted malaria infections and related fatalities in Africa.

However, the World Health Organization (WHO) recently wrote, 'Given current trends, progress towards critical targets of the WHO global malaria strategy is off track.'

According to a Correspondence published by the journal Nature Medicine on January 3, 2025, innovative public health measures have reduced malaria-related mortality in Africa from 808,000 in 2000 to 580,000 in 2022.

In fact, nine African countries have already eradicated malaria, including the North African countries of Egypt, Libya, Tunisia, Algeria, and Morocco, and a few sub-Saharan countries, Lesotho, Mauritius, Seychelles, and Cabo Verde.

These authors from the Africa Centres for Disease Control and Prevention in Ethiopia wrote, 'This progress is threatened by climate change, the emergence of drug-resistant strains, and new variants of mosquitos. Introducing and scaling malaria vaccines could enhance global malaria elimination efforts.'

Malaria vaccines became more available in Africa last year after the WHO endorsed two malaria vaccines. These vaccines are:

GSK's Mosquirix™ RTS, S/AS01 (RTS,S) recombinant vaccine has made a positive impact in a limited amount of time. During its introduction, over two-thirds of children who reportedly did not sleep under an insecticide-treated net received at least one dose of RTS,S/AS01.

The Serum Institute of India's R21/Matrix-M™ malaria vaccine was co-produced by scientists at the University of Oxford and Novavax AB. In October 2024, TIME awarded R21/Matrix-M™ a 'Best Inventions of 2024.

Unfortunately, Africa's 1 billion population currently demands more of the R21 vaccine than production can meet. Once this vaccine shortage is resolved, international visitors to Africa may gain access, reducing the number of travel-related cases in the United States.

About 2,000 cases of malaria are diagnosed in the U.S. in a typical year, mainly in the millions of people returning travelers from Africa.

As of November 23, 2024 (Week 47), the U.S. CDC reported 1,772 malaria cases this year. From a state perspective, Florida recorded 68 cases of travel-related malaria after visiting malaria-endemic areas, such as Nigeria.

Since the U.S. FDA has not approved either malaria vaccine as of January 6, 2024, the CDC recommends preventing malaria infections by taking antimalarials before and after traveling and preventing mosquito bites while abroad.

Sub Title:

Malaria Vaccines are approved for use in Africa not the USA

References:

Resurgence of malaria and artemisinin resistance in Africa

US CDC Malaria

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Malaria Day in the Americas 2024

Karen McClorey Hackett — Wed, 06 Nov 2024 18:28:34 +0000

Reviewer:

Robert Carlson, MD

On Malaria Day in the Americas 2024, the Pan American Health Organization (PAHO) is urging everyone in the fight against Malaria to join forces to expand access to diagnosis and treatment to accelerate elimination.

The PAHO stated on November 6, 2924, "Expanding access to malaria diagnosis and treatment without barriers" is a call to develop actions so that malaria treatment is within the reach of communities without geographic or financial barriers.

While the WHO African Region shoulders the heaviest burden of malaria outbreaks, the PAHO estimates 41 million people live in 21 areas in the Region of the Americas where the risk of infection by mosquito-carrying Malaria is considered moderate to high.

In 2023, countries in the Americas reported 505,000 cases of Malaria, a 5% increase from 2022. Brazil, Colombia, and Venezuela report the most malaria cases in the Americas.

In 2022, 481,788 cases of Malaria and around 92 deaths were reported by the PAHO in 2022.

While the increase in transmission is concerning, PAHO Director Dr. Jarbas Barbosa stated in a press release that with accelerated efforts, "this disease can be eliminated in our Region."

In the United States, the CDC recently confirmed 1,610 travel-related malaria cases during 2024, mostly in international travelers arriving in New York City (220), Texas, Miami, Florida, and Los Angeles, California.

Last year, the CDC confirmed ten locally acquired malaria cases in the U.S.

Malaria is an acute febrile disease caused by the parasite Plasmodium, transmitted by the bite of an infected female Anopheles mosquito. Symptoms include fever, headache, and chills, which may be mild. Left untreated, Malaria can progress to severe illness and even death, says the WHO.

From a prevention perspective, two WHO-recommended malaria vaccines are available in Africa but not in the Americas.

In October, the Serum Institute of India Pvt. Ltd.'s R21/Matrix-M™ vaccine was awarded innovation of the year. The R21 vaccine also includes the Matrix-M adjuvant from Maryland-based Novavax Inc., which amplifies the immune response generated by the vaccine.

Sub Title:

Malaria is a vaccine preventable disease

Reference:

Malaria Day in the Americas 2024

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Malaria Vaccine Changed the Game, Awarded Innovation of the Year

Karen McClorey Hackett — Fri, 01 Nov 2024 14:04:13 +0000

Reviewer:

Robert Carlson, MD

Time USA LLC recently announced its list of the 'Best Inventions of 2024', identifying 200 innovations that changed people's lives.

On October 31, 2024, Time revealed it had selected an innovative vaccine that may save hundreds of thousands of lives each year.

Earlier this year, the World Health Organization (WHO) recommended a second vaccine to combat malaria outbreaks, which sickens hundreds of millions and kills about 600,000 people each year.

The Serum Institute of India Pvt. Ltd.'s R21/Matrix-M™ vaccine was released in 2023 following initial development by researchers at Oxford University. Serum began shipping the vaccine in May 2024 and anticipates distributing over 50 million doses annually.

R21 also includes the Matrix-M adjuvant from Maryland-based Novavax Inc., which amplifies the immune response generated by the vaccine.

John Jacobs, Novavax's President, and CEO, said in a press release on July 15, 2024, "The introduction of the R21/Matrix-M™ malaria vaccine in Côte d'Ivoire marks a breakthrough in the fight to protect vulnerable children against a leading cause of death across the region while reinforcing our mission to create innovative vaccines that improve public health."

As of November 1, 2024, the WHO says the African Region shoulders the heaviest burden of this mosquito-transmitted disease this year in countries such as Burkina Faso, Cameroon, Ethiopia, the Democratic Republic of the Congo, Ghana, Mali, Mozambique, Niger, Nigeria, Sudan, Uganda, and Tanzania.

To inform travelers about global health risks such as malaria, the U.S. CDC publishes Travel Health Notices.

In the United States, the CDC has confirmed 1,576 malaria cases during 2024, mostly in international travelers arriving from Africa in New York City, Miami, Florida, and Los Angeles, California.

While the WHO recommends both malaria vaccines when visiting malaria-endemic areas, neither is available in the U.S.

Note: TIME Best Inventions has a paid application process through which companies may submit their products and organizations for editorial consideration. Applying does not guarantee inclusion. All decisions throughout the editorial process—from selecting candidates to finalizing the pieces on their achievements—are made by TIME's journalists based on relevancy and core editorial principles.

Sub Title:

Novavax R21 adjuvant amplifies the immune response generated by the malaria vaccine

References:

TIME - The Best Inventions of 2024

First nation to deploy R21/Matrix-M Malaria Vaccine

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France's Airports Report Increased Odyssean Malaria Cases

Karen McClorey Hackett — Mon, 14 Oct 2024 14:04:25 +0000

Reviewer:

Robert Carlson, MD

In recent years, there has been an increase in locally acquired malaria cases in Europe related to travelers returning from Africa, which shoulders the heaviest burden (90%+) of malaria disease reported.

In 2022, over 99% of Europe's 6,131 malaria cases (mean age 37.9 yrs) were travel-related.

To guide control measures, researchers analyzed two decades of data for locally acquired malaria in France to identify potential changes in the parasite's mode and frequency of transmission.

In France, the Paris Charles de Gaulle airport vicinity reported most cases. The Brussels airport area had the second-highest number of malaria cases in Europe,

Published by Eurosurveillance on October 10, 2024, this study revealed that locally acquired malaria cases in France have remained steady between 1995 and 2022.

However, since 2011, more cases have been caused by the bite of an infectious exotic mosquito imported via plane, luggage, or parcel, known as Odyssean malaria.

Odyssean malaria is defined as malaria in a person with no history of recent travel to a malaria-endemic region. It is also colloquially known as airport, suitcase, minibus, or taxi-rank malaria.

Airport malaria describes a Plasmodium infection acquired at or near an airport resulting from a bite from an infectious mosquito transported by aircraft from a malaria-endemic area.

Luggage malaria is further distinguished by the transport of the infectious mosquito in baggage and its release at a site of infection away from an airport.

These researchers wrote, 'Given the significant risk to patients due to a delayed diagnosis, physicians should consistently consider the possibility of locally acquired malaria in patients presenting with unexplained fever, even without a travel history, especially when thrombocytopenia is documented.'

Among patients in France with locally acquired malaria, severe cases and deaths have been more frequent than in imported cases, primarily when the patient is located near an international airport.

Furthermore, a related Systematic Review recommended, 'Strict disinfection of aircraft is crucial to prevent Odyssean malaria, and hygiene precautions are essential to contain malaria cases in healthcare settings.'

In the United States, the Centers for Disease Control and Prevention (CDC) reported 1,447 malaria cases in the U.S. Territories and non-U.S. residents during the week ending October 5, 2024.

In Florida, 57 cases of malaria have been reported in individuals with a travel history to a malaria-endemic area, such as Africa (Nigeria) and Central and South America. Last year, the CDC published a Morbidity and Mortality Weekly Report confirming local malaria cases in Florida (Sarasota, seven).

As of October 14, 2024, malaria is a vaccine-preventable disease. WHO-approved malaria vaccines are available in various African and European countries but not in the U.S.

Sub Title:

Malaria vaccines are available in Africa in 2024

References:

Locally acquired malaria: a retrospective analysis of long-term surveillance data, European France, 1995 to 2022

Systematic Review Open Access Like0 Download Airport and luggage (Odyssean) malaria in Europe: a systematic review

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ECDC travel related malaria map September 2024

Preconception Malaria Immunization Found Safe

Karen McClorey Hackett — Wed, 21 Aug 2024 10:46:02 +0000

Reviewer:

Robert Carlson, MD

The U.S. National Institutes of Health (NIH) recently supported clinical trials of an experimental malaria vaccine in adults and found that all three tested regimens were safe.

One of the trials enrolled healthy women who anticipated becoming pregnant soon after immunization.

That trial began with drug treatment to remove malaria parasites, followed by three injections spaced over a month of either saline placebo or the investigational vaccine at one of two dosages.

Both dosages of the vaccine candidate conferred a significant degree of protection from parasite infection, and clinical malaria was sustained for two years without the need for a booster dose, which was the first for any malaria vaccine.

In an exploratory analysis of women who conceived during the study, the vaccine significantly protected them from malaria during pregnancy. If confirmed through additional clinical trials, the approach modeled in this study could lead to improved ways to prevent malaria during pregnancy.

The researchers speculate that the PfSPZ Vaccine might avert malaria-related early pregnancy losses since parasitemia risk during the periconception period was reduced by 65 to 86%.

This is an important finding since malaria parasites, including those of the species Plasmodium falciparum (Pf), can cause illness in people of any age, including pregnant women and infants, who are especially vulnerable to life-threatening diseases.

Malarial parasitemia in pregnancy is estimated to cause up to 50,000 maternal deaths and 200,000 stillbirths in Africa each year.

Investigators from the NIH’s National Institute of Allergy and Infectious Diseases (NIAID) and the University of Sciences, Techniques and Technologies, Bamako, Mali, co-led the trials.

The vaccine candidate was the PfSPZ Vaccine, a radiation-attenuated vaccine based on Pf sporozoites (a stage of the parasite’s lifecycle) manufactured by Sanaria Inc.

Previous clinical trials of the PfSPZ Vaccine have shown it to be safe.

Results published in 2022, for example, an NIAID-sponsored, placebo-controlled trial of a three-dose regimen of PfSPZ Vaccine in Burkina Faso found that the vaccine had up to 46% efficacy that lasted at least 18 months.

“Preconception immunization is a new strategy to reduce mortality for women with malaria in pregnancy,” the researchers noted in a press release on August 14, 2024.

They plan to investigate the safety of the PfSPZ Vaccine administered during pregnancy, then examine the efficacy of PfSPZ given preconception or during pregnancy in more extensive clinical trials.

“Existing measures are not protecting women from malaria in pregnancy,” they added. “A safe and effective vaccine is urgently needed, and our results indicate PfSPZ Vaccine might be a suitable candidate,” they conclude.

As of August 2024, there are two WHO-recommended malaria vaccines. The Serum Institute of India has manufactured about 25 million R21/Matrix-M™ vaccines for distribution in Africa.

Malaria vaccines are offered in Africa but not in the United States.

About 2,000 malaria cases are confirmed in the U.S. related to international travel. For example, Florida has reported 31 such cases, primarily from travelers to Africa as of August 2024.

Sub Title:

Sanaria Inc PfSPZ Vaccine candidate shown it to be safe for pregnant women

Reference:

Safety and efficacy of PfSPZ Vaccine against malaria in healthy adults and women anticipating pregnancy

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When Are Malaria Vaccines Most Effective

Karen McClorey Hackett — Wed, 07 Aug 2024 20:35:23 +0000

Reviewer:

Robert Carlson, MD

Malaria vaccine candidates have been in development since the 1960s, but innovative vaccines have made substantial progress in the last decade.

Gavi, the Vaccine Alliance, recently wrote that the recent launch of malaria vaccinations in Africa marks a turning point in the age-old battle against this mosquito-transmitted disease.

While both World Health Organization-recommended vaccines target the same protein on the surface of malaria parasites and are expected to reduce malaria cases and deaths, interpreting their efficacy can be challenging.

This is because efficacy measurements are not directly comparable due to differences in clinical study design.

Various studies have shown that vaccine efficacy is improved when using a seasonal approach, which means administering vaccines seasonally compared to an age-based approach.

A recent study observed that rainfall and temperature are significant drivers of malaria seasonality in all parts of Sub‐Saharan Africa except in West Central Africa. In Sub‐Saharan Africa, seasonal malaria transmission is sustained at temperatures well above 15°C or below 40°C with maximum monthly rainfall not exceeding 600 mm.

For example, the phase 3 clinical trial of the R21/Matrix-M™ vaccine evaluated an age-based vaccination approach in three study sites and seasonal vaccination in two.

Age-based vaccination in the R21 trial included study sites in low—to moderate-transmission areas but did not include sites with year-round high transmission settings.

When the R21 vaccine was provided just before the malaria season in areas of seasonal transmission, malaria episodes were reduced by 75% in the first year following vaccination.

This is important because neither malaria vaccine provides complete protection against infection.

Both vaccines target malaria parasites during the ‘sporozoite’ stage of their lifecycle, where they first enter the human body and begin replicating in liver cells.

“In areas – and periods – with high transmission, the immune system is under a significant assault due to repeated biting from mosquitos,” says Dr. W. Scott Gordon, Head of Gavi’s Malaria Vaccine Programme, in a VaccinesWork article published on July 29, 2024.

“Each bite can transmit as many as 1,000 sporozoites, so even a tiny proportion of those getting through can result in the immunized child still coming down with malaria and lower measured efficacy from the vaccine.”

“This is one reason why WHO prioritizes the use of malaria vaccines in moderate to high transmission areas, where public health impact is expected to be highest.”

“We don’t know what the duration of protection with R21 is because it hasn’t been studied for long enough yet (as clinical trials are ongoing),” said Prof Brian Greenwood at the London School of Hygiene and Tropical Medicine, UK.

So, where does this leave us?

The bottom line is that two effective malaria vaccines are now available in Africa, ensuring millions of children have access to malaria prevention.

The completed, unedited article by Linda Geddes is posted at this link.

The University of Oxford Jenner Institute created R21 in 2017, and Novavax AB produces Matrix-M. As of August 2024, Mozambique, South Sudan, the Central African Republic, Côte d'Ivoire, Ghana, Nigeria, and Burkina Faso issued their authorization for deploying the R21 vaccine.

Sub Title:

Over 25 million R21 Matrix-M vaccines produced by Serum Institute of India

References:

How effective are malaria vaccines?

Malaria Transmission Seasonality and Their Relative Importance in Sub-Saharan Africa

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Another Country Offers Second-Gen Malaria Vaccine

Donald Hackett — Wed, 17 Jul 2024 14:59:13 +0000

Reviewer:

Robert Carlson, MD

In collaboration with UNICEF, the World Health Organization (WHO), and Gavi, South Sudan's Ministry of Health, today announced the official launch of a nationwide R21/Matrix-M™ malaria vaccine distribution.

This initiative comes after the arrival of the first shipment of over 645,000 doses of the R21 malaria vaccine in Juba on May 31, 2024. These vaccines were initially delivered to South Suda's 28 counties with the highest malaria burden, with plans to expand the distribution to cover the entire nation.

Confirmed on July 16, 2024, this landmark event marks a significant stride in the country's efforts to safeguard the health and well-being of its children.

About 15 African countries are expected to introduce malaria vaccines in 2024 and 2025 to protect around 6.6 million children.

"The rollout of the malaria vaccine is a game-changer in our fight against this deadly disease. With the support of our partners, we are committed to protecting young children and reducing the malaria burden in the country," said Dr. Humphrey Karamagi, WHO Representative for South Sudan, in a press release.

"WHO AFRO has deployed experts to support the rollout, ensuring the effective introduction and distribution of the malaria vaccine by leveraging extensive expertise from prior vaccine initiatives within the region."

Over the past month, the R21 vaccine has also been offered in Côte d'Ivoire and the Central African Republic.

The University of Oxford Jenner Institute began work on R21 in 2017. The R21/Matrix-M vaccine includes Novavax AB proprietary saponin-based Matrix-M adjuvant and is licensed to and manufactured by the Serum Institute of India Private Ltd.

John Jacobs, President and Chief Executive Officer of Novavax, commented in a press release on July 15, 2024, "The introduction of the R21/Matrix-M™ malaria vaccine in Côte d'Ivoire marks a breakthrough in the fight to protect vulnerable children against a leading cause of death across the region while reinforcing our mission to create innovative vaccines that improve public health."

"Novavax is proud of the contribution of our Matrix-M™ adjuvant in this vaccine and in making this moment possible, and value our continued collaboration with the University of Oxford and Serum Institute of India, as well as the lifesaving work of WHO, Gavi, and UNICEF."

While about 90% of malaria cases are reported in Africa, international travelers have brought this mosquito-transmitted disease to the United States.

For example, Florida's Health Department confirmed in July 2024 that twenty-eight cases of malaria with onset in 2024 have been reported in individuals with a travel history to a malaria-endemic area, primarily countries in Africa.

In 2023, seven locally acquired malaria cases were reported near Sarasota, Florida.

As of July 17, 2024, the U.S. FDA has not approved the WHO-recommended malaria vaccines.

Sub Title:

R21 Malaria vaccine available in South Sudan

References:

R21 vaccine in South Sudan

Côte d’Ivoire to deploy R21/Matrix-M™ Malaria Vaccine

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Thursday, July 18, 2024 - 05:15

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US CDC South Sudan map July 2024

Single-dose Malaria Medicine Prevents Relapse

Karen McClorey Hackett — Fri, 05 Jul 2024 11:23:44 +0000

Reviewer:

Robert Carlson, MD

GSK plc and Medicines for Malaria Venture today announced that the first single-dose of tafenoquine, co-administered with chloroquine for a radical cure, for the prevention of relapse of Plasmodium vivax (P. vivax) malaria, has now been launched in Thailand and Brazil.

In response to the ongoing public health emergency, the government of Brazil accelerated the introduction of tafenoquine in March 2024. The rollout of this new testing and treatment option has begun within the public health system.

In Brazil, malaria cases in indigenous population villages are predicted to reach over 51,000 in 2024. Relapses also increase the disease burden and the potential for onward transmission, ultimately impeding global efforts to eliminate malaria.

Dr. Marcus Lacerda, Tropical Medicine Foundation Dr. Heitor Vieira Dourado and Principal Investigator for the Tafenoquine Rollout STudy, said in a press release on July 5, 2024, “The launch of tafenoquine in Brazil marks a significant step forward in our country’s mission to eliminate malaria by 2035."

Tafenoquine is an 8-aminoquinoline, antimalarial drug targeting the liver-stage of P. vivax malaria. Tafenoquine, like all 8-aminoquinolines, has the potential to cause acute hemolytic anemia in people with glucose-6-phosphate dehydrogenase (G6PD) deficiency.

Therefore, a G6PD test must be performed before prescribing.

When combined with chloroquine for the blood-stage infection, tafenoquine provides what is known as a radical cure: the treatment of both the disease's blood- and liver stages.

P. vivax is the dominant malaria parasite in most countries outside of sub-Saharan Africa.

Approvals for tafenoquine have been granted in the U.S. (ARAKODA™), Australia, Brazil, Ethiopia, Guyana, Peru, Thailand, Colombia, and the Philippines, and the drug is undergoing marketing authorization evaluation in several other countries where P. vivax is endemic.

According to the Centers for Disease Control and Prevention, about 2,000 malaria cases are diagnosed in the United States annually, mostly in travelers. However, in 2023, seven locally acquired malaria cases were reported in the Sarasota, Florida, area.

In Africa, two malaria prevention vaccines have been authorized.

The World Health Organization (WHO) recommends Mosquirix™ and R21 / Matrix-M™ vaccines. The WHO estimates the annual global demand for malaria vaccines is about 40–60 million doses by 2026.

R21/Matrix-M includes Novavax AB saponin-based Matrix-M adjuvant and is licensed to and manufactured by the Serum Institute of India Private Ltd.

Neither malaria vaccine is available in the United States in 2024.

Sub Title:

Tafenoquine is an antimalarial drug targeting the liver-stage of P vivax malaria

References:

Brazil and Thailand become first malaria-endemic countries to launch new single-dose radical cure medicine to prevent the relaps

US FDA Approves ARAKODA™ (tafenoquine)

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US CDC Malaria map June 2024

$9 Billion Needed to Save 8 Million Children

Karen McClorey Hackett — Fri, 21 Jun 2024 19:45:51 +0000

Reviewer:

Robert Carlson, MD

Gavi, the Vaccine Alliance, has confirmed it is seeking $9 billion in new funding to immunize children against more diseases faster than ever.

Dr. Sania Nishtar, CEO of Gavi, presented the latest Investment Opportunity on June 20, 2024, outlining how the Alliance, if fully funded, could protect 500 million children in its next five-year strategic period, potentially saving over 8 million lives.

Previously, Gavi vaccinated one billion children between 2000 and 2020.

With Gavi's funding replenishment process for 2026–2030 only beginning, early pledges from the United States, France, Spain, the private sector, and philanthropic donors worth at least $2.4 billion.

Meanwhile, countries implementing Gavi programs are expected to contribute over 40% of their routine vaccine costs during the next strategic period.

This amount compares to 10% just fifteen years ago, reflecting a significant shift in local commitments.

At the same time, Gavi immunization programs are expected to generate at least $100 billion in economic benefits for implementing countries.

In its next five-year strategy, Gavi will aim to reach at least 50 million children with four doses of the malaria vaccine.

As of June 2024, two malaria vaccines are being offered in Africa.

In late 2023, the World Health Organization recommended the R21/Matrix-M vaccine to prevent malaria in African children.

In addition to financial commitments, various vaccine manufacturers also stepped up to support vaccine access:

South Africa announced partnerships with South Korea to manufacture a pentavalent meningitis vaccine in Africa and with France, an inactivated polio vaccine.
Sanofi also announced a continued investment in a new Yellow Fever vaccine based on innovative cell culture technology.
Institut Pasteur de Dakar of Senegal announced investments to expand the production of the Yellow Fever vaccine and develop innovative antigen platforms for measles-rubella and mRNA vaccines.
EuBiologics announced an investment to expand the supply of its newly pre-qualified cholera vaccine with the optimized formulation.
Atlantic Lifesciences of Ghana announced a partnership to produce HPV vaccines.

A specific declaration was also made to support the local production of vaccines against cholera.

As of June 2024, the global shortage of cholera vaccines continues.

"We are incredibly grateful for the strong support we received today from donors as we prepare for an intense resource mobilization period. We are also grateful to countries for their political commitment to vaccine equity. And to Gavi’s stakeholders with whom we strive daily to improve lives and livelihoods," said Dr. Nishtar in a press release on June 21, 2024.

Sub Title:

Five hundred million children to be vaccinated in five years

Reference:

Gavi, the Vaccine Alliance unveils plans for next 5-year period

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by Ian Ingalula