610,000 deaths in 2024. Estimates of malaria deaths reached 610,000 in 2024 compared to 597,000 in 2023. Deaths are increasing by 2% year-on-year, and the disease primarily strikes the youngest: in the WHO African region, 75% of malaria victims are children under 5 years old. Yet a decisive milestone is being reached in 2025: 24 African countries now offer malaria vaccines as part of childhood vaccination programs.
This first massive vaccination campaign against malaria targets more than 10 million children annually with two vaccines now available. Africa, which accounts for 95% of global cases and 95% of deaths, now has for the first time vaccination prevention tools adapted to its most exposed populations.
Two Vaccines Transform Malaria Prevention
The rollout relies on two complementary vaccines: RTS,S (Mosquirix) recommended by WHO in 2021 and R21/Matrix-M recommended by WHO in October 2023. Clinical data confirm substantial efficacy for both products.
RTS,S demonstrates a 13% reduction in overall child mortality in pilot programs conducted in Ghana, Kenya, and Malawi between 2019 and 2023. This reduction exceeds initial projections because the vaccine provides indirect protection against other pathogens by strengthening the overall health status of vaccinated children.
R21/Matrix-M demonstrates higher efficacy: 75% vaccine efficacy over 12 months in areas of seasonal transmission and 68% in areas of perennial transmission. The 5 to 17-month age group, the primary beneficiary of large-scale deployment, shows the highest vaccine efficacy over 12 months: 79% in seasonal sites and 75% in standard sites.
Since 2023, more than 12 million vaccine doses financed jointly by Gavi and countries have been purchased and delivered by UNICEF. The scale of this logistical coordination is notable for a vaccine specifically designed for sub-Saharan Africa.
Africa Takes Control of Its Vaccine Production
The supply strategy changes the game. The R21/Matrix-M vaccine is licensed to the Serum Institute of India, the world’s largest vaccine manufacturer, which has already established production capacity of 100 million doses per year, to be doubled over the next two years.
Global annual demand for malaria vaccines is estimated at 40-60 million doses by 2026 alone, reaching 80-100 million doses per year by 2030. India, Africa’s historic partner in the pharmaceutical sector, thus becomes the primary supplier of a vaccine designed for African needs.
The cost of R21/Matrix-M is announced at less than 5 dollars per injection, a price accessible to African health budgets. This rate, significantly lower than prices charged by major Western laboratories, reflects a South-South cooperation logic.
Financing follows this partnership logic. Between 2026 and 2030, Gavi aims to support countries in reaching at least 50 million children with malaria vaccines. Achieving this objective requires considerable investment: in 2024, available malaria funding of 3.9 billion dollars fell well short of the Global Technical Strategy’s target of 9.3 billion dollars.
14 Countries Introduce Vaccination Simultaneously in 2024
The year 2024 saw massive and rapid deployment. Fourteen countries introduced vaccines for the first time in 2024: Cameroon, Burkina Faso, Sierra Leone, Benin, Liberia, Côte d’Ivoire, South Sudan, Mozambique, Central African Republic, Niger, Chad, Democratic Republic of Congo, Sudan, and Nigeria.
The total malaria burden in the 17 African countries currently vaccinating children represents 70% of the global burden according to the 2024 World Malaria Report. The targeting strategy prioritizes areas where health impact will be greatest.
Early feedback from Cameroon, a pilot country since January 2024, confirms operational effectiveness. Data published this month by Cameroon’s Expanded Programme on Immunization revealed that districts included in the first vaccination wave experienced a larger decline, of 17% in all hospital and clinic consultations for children.
Eight additional countries plan to introduce the malaria vaccine into their childhood vaccination programs in 2025, and 13 have obtained Gavi support to expand their national programs. Momentum is accelerating despite persistent logistical and financial constraints.
Limitations Reveal Structural Challenges
The rollout nevertheless reveals significant constraints. Most countries are implementing programs below their national expansion targets due to limited funding. Vaccine supply alone is insufficient to bridge the financing gap.
Treatment resistance also complicates the health equation. Partial resistance to artemisinin derivatives – the backbone of malaria treatments following the failure of chloroquine and sulfadoxine-pyrimethamine – has been confirmed or suspected in at least 8 African countries. The threat to curative treatment effectiveness reinforces the urgency of preventive approaches.
Climate impact worsens the epidemiological situation. According to the African Leaders Malaria Alliance report, the number of months conducive to malaria transmission in African highlands has increased by 14%. Malaria is gaining ground in territories where it did not previously exist.
A Still Fragile Health Revolution
For the first time, Africa has direct immunological protection against its leading cause of childhood mortality, after decades when only bed nets and curative treatments were available.
The India-Africa partnership for vaccine production bypasses Western pharmaceutical circuits and demonstrates the Global South’s capacity to meet its own health needs. Reducing unit cost to less than 5 dollars per dose makes massive vaccination coverage possible in economies with constrained health budgets.
But the window of opportunity remains narrow. A 20% decrease in health funding could result in 12 million additional child deaths by 2045. The efficacy of available vaccines, while substantial, does not guarantee eradication without sustained funding for other complementary interventions.
The question is now financial and political: will Africa succeed in maintaining the flow of necessary investments for these vaccines to deliver on their promise?