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In recent developments, the fight against malaria has seen significant advancements, particularly in the rollout and development of malaria vaccines.
As of January 2025, the routine immunization program for malaria vaccines in Africa has achieved a milestone, with nearly 10 million doses of the malaria vaccine delivered across the continent in the first year of the program. This initiative, supported by the Gavi vaccine alliance, has been rolled out in 17 African countries, including Ghana, Kenya, Malawi, and Cameroon, among others. The vaccines, specifically RTS,S and R21/Matrix-M, have shown promising results, with a 13% drop in mortality and substantial reductions in severe malaria illness and hospitalizations during the pilot phase from 2019 to 2023[1][3].
The RTS,S and R21/Matrix-M vaccines are recommended by the World Health Organization (WHO) for the prevention of _Plasmodium falciparum_ malaria in children living in malaria-endemic areas. Both vaccines have been prequalified by WHO and have demonstrated high public health impact, reducing malaria cases by more than half during the first year after vaccination. A fourth dose given in the second year of life prolongs this protection[3].
In addition to these existing vaccines, new breakthroughs are on the horizon. The PfSPZ-LARC2 vaccine, developed by scientists at Sanaria and the Seattle Children's Research Institute, offers high-level protection with just one dose. This vaccine employs genetic engineering to ensure the malaria parasites replicate only in the liver and not in the blood stage, where they could cause disease. The PfSPZ-LARC2 vaccine has the potential to achieve up to 90% protection against malaria infection, making it a significant advancement in global health efforts[2].
Meanwhile, other research initiatives are also gaining traction. Ocean Biomedical has received additional funding from the National Institutes of Health (NIH) to advance their malaria vaccine research. Led by Dr. Jonathan Kurtis, the team is studying naturally occurring immune responses in children who have developed resistance to malaria, focusing on a unique protein called glutamic acid-rich protein (GARP). This research aims to develop a vaccine that blocks the malaria parasite's ability to enter and exit red blood cells, with potential human trials as early as the fourth quarter of 2025[5].
Despite these positive developments, challenges persist. The recent freezing of US aid to malaria projects has raised concerns about the impact on global malaria control efforts. The US had been a major contributor to malaria funding, providing up to $1 billion annually. The sudden cut in funding comes at a critical time, with new variants of the disease spreading in Africa and the emergence of drug and insecticide resistance. This disruption could severely affect supply chains, rural hospitals, and programs aimed at controlling the disease[4].
In summary, while significant progress has been made in the rollout and development of malaria vaccines, ongoing challenges, including funding cuts and emerging resistance, highlight the need for continued support and innovation in the fight against malaria. -
In recent developments, the global fight against malaria has seen both challenges and significant advancements, particularly with the ongoing implementation of new malaria vaccines.
Climate change is posing a formidable threat to the progress made in eradicating malaria. Rising temperatures and altered rainfall patterns are expanding the geographic distribution of mosquitoes that spread the disease. According to the World Health Organization's (WHO) latest World Malaria Report, warming temperatures are extending the breeding season for mosquitoes and speeding up the growth cycle of malaria parasites, potentially undermining gains in vulnerable regions[1].
Despite these challenges, the introduction of new malaria vaccines has marked a significant milestone. The R21/Matrix-M vaccine, recently endorsed by the WHO, has demonstrated unprecedented safety, efficacy, and cost-effectiveness in phase III trials published in February 2024. This vaccine, along with the RTS,S/AS01 vaccine, has been shown to reduce malaria cases by more than half during the first year after vaccination, with a fourth dose prolonging protection[2][3].
The rollout of these vaccines is well underway, with 17 countries in Africa already incorporating them into their childhood immunization programs as of December 2024. Additional countries are expected to follow suit in 2025. The Central African Republic, for instance, introduced the R21/Matrix-M vaccine into its routine Expanded Programme on Immunization (EPI) in August 2024, aiming to vaccinate around 200,000 children. This initiative is supported by WHO, UNICEF, and Gavi, the Vaccine Alliance, and is seen as a major step in reducing early child deaths and strengthening the fight against malaria[5].
The impact of these vaccines is already being observed. The RTS,S/AS01 vaccine, which has been in use since 2019, has been linked to a 13% reduction in deaths from all causes except injury and a 22% reduction in hospitalizations for severe malaria in countries like Ghana, Kenya, and Malawi[4].
However, challenges persist, including the evolution of malaria parasites and mosquitoes. Malaria parasites have developed resistance to nearly every drug deployed against them, including partial resistance to artemisinin in several African countries. Additionally, mosquitoes are evolving resistance to insecticides and expanding their geographic range, further complicating control efforts[4].
In conclusion, while climate change and evolutionary adaptations of malaria parasites and mosquitoes present ongoing hurdles, the introduction and widespread implementation of effective malaria vaccines like R21/Matrix-M and RTS,S/AS01 offer a promising avenue in the global fight against this deadly disease. -
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In recent developments, the global fight against malaria is facing significant challenges and advancements. A critical issue has arisen with the sudden freezing of US aid to malaria projects, which could have devastating consequences, particularly in Africa.
The US government, which has been a major contributor to global malaria control efforts, providing up to $1 billion annually, has halted this funding as part of broader cuts to foreign aid. This move comes at a perilous time, as new variants of malaria are spreading in Africa, and signs of drug and insecticide resistance are emerging in countries such as Eritrea, Ethiopia, South Sudan, Sudan, and Uganda[1].
The impact of these funding cuts is already being felt, with organizations like the Malaria Consortium forced to lay off staff and halt critical programs. For instance, the Malaria Consortium has had to terminate a program in Mozambique and suspend a mosquito monitoring and control training program in Asia. These cuts not only affect the immediate operations but also disrupt the supply chains, rural hospitals, and programs for distributing mosquito nets, exacerbating the financial burden on poor families who need to seek medical care for their children[1].
Despite these challenges, there is promising news on the vaccination front. The R21/Matrix-M malaria vaccine has been endorsed by the World Health Organization (WHO) and is being integrated into routine immunization programs in several countries. This vaccine has shown unprecedented safety, efficacy, and cost-effectiveness in phase III trials published in The Lancet earlier this year. It reduces uncomplicated malaria by around 40%, severe malaria by 30%, and all-cause mortality by 13%[2][3].
The Central African Republic recently became the fourth country to introduce the R21/Matrix-M vaccine into its routine Expanded Programme on Immunization (EPI), following Côte d'Ivoire. This initiative, supported by WHO, UNICEF, and Gavi, the Vaccine Alliance, aims to protect children in endemic areas through vaccination, in addition to other preventive measures like insecticide-treated nets and environmental sanitation[5].
In other regions, such as Plateau State in Nigeria, significant strides have been made through seasonal malaria chemoprevention programs. Over one million children received free prophylactic drugs in 2024, leading to a reduction in malaria prevalence from 23% in 2018 to 15% in recent data. This program, administered by the Plateau State Malaria Elimination Programme in partnership with the Malaria Consortium, has trained thousands of ad-hoc staff to reach even the hardest-to-reach communities[4].
As the global community grapples with the immediate consequences of funding cuts, the introduction and expansion of effective malaria vaccines like R21/Matrix-M offer a beacon of hope in the ongoing battle against this deadly disease. However, sustained funding and concerted efforts will be crucial to ensure the widespread implementation and maximum impact of these vaccines. -
In the ongoing battle against malaria, recent developments have marked significant milestones, particularly with the advancement and implementation of malaria vaccines.
Over the past year, the rollout of malaria vaccines in Africa has been nothing short of remarkable. As of January 2025, nearly 10 million doses of malaria vaccines have been delivered across the continent, with routine immunization programs expanding to include 17 countries, including Ghana, Kenya, Malawi, and Cameroon[4].
The vaccines in question are the RTS,S and the more recently endorsed R21/Matrix-M. The R21/Matrix-M vaccine has garnered considerable attention due to its high efficacy, safety, and cost-effectiveness. A phase III trial published in February 2024 highlighted the vaccine's unprecedented performance, especially in highly seasonal malaria settings[2][3].
The World Health Organization (WHO) has recommended both vaccines for use in children living in areas with moderate to high malaria transmission. These vaccines have shown promising results, reducing uncomplicated malaria by around 40%, severe malaria by 30%, and all-cause mortality by 13%[3][4].
In specific countries, the impact is already being felt. For instance, in Cameroon, which began its routine vaccination program in January 2024, there has been a notable reduction in deaths among children under five. This is particularly significant in a country where malaria claims over 13,000 lives annually and accounts for nearly 30% of all hospital consultations[4].
The Central African Republic (CAR) is another country that has recently introduced the R21/Matrix-M vaccine into its routine Expanded Programme on Immunization (EPI). With support from WHO, UNICEF, and funding from Gavi, the Vaccine Alliance, CAR aims to protect around 200,000 children with the new vaccine. This initiative is seen as a critical step in preventing malaria and saving thousands of young lives each year[5].
Despite these advancements, challenges persist. Ensuring vaccine distribution, access, and acceptance in affected regions remains a significant hurdle. However, the early results are promising, and ongoing efforts to expand vaccination programs to more countries are expected to protect millions more children in the coming years. Gavi plans to expand the program to up to eight further African countries in 2025 and aims to help countries protect an additional 50 million children with four doses of the malaria vaccine from 2026 to 2030[4].
As the global fight against malaria continues, the introduction and widespread implementation of these vaccines represent a crucial breakthrough, offering new hope in the quest to eradicate this deadly disease. -
In the ongoing battle against malaria, a disease that affects millions globally, particularly in Africa, recent developments have brought significant hope and progress.
One of the most promising advancements is the R21/Matrix-M malaria vaccine, which has garnered substantial attention and endorsement. The World Health Organization (WHO) has recommended this vaccine for use in children living in areas with moderate to high malaria transmission. This recommendation follows successful phase III trials published in February 2024, which demonstrated the vaccine's unprecedented safety, efficacy, and cost-effectiveness[2][3].
The R21/Matrix-M vaccine has shown high efficacy in highly seasonal malaria settings and good efficacy in age-based administration in low-to-moderate endemicity settings. It reduces uncomplicated malaria by around 40%, severe malaria by approximately 30%, and all-cause mortality by 13%[3].
Recently, the Central African Republic (CAR) introduced the R21/Matrix-M vaccine into its routine Expanded Programme on Immunization (EPI), marking a significant step in preventing the disease and protecting children's lives. This move follows similar introductions in Côte d'Ivoire and other countries. The CAR received 163,800 doses of the vaccine in May 2024, which are being rolled out to all eligible children. This initiative is supported by WHO, UNICEF, and Gavi, the Vaccine Alliance, with a focus on developing vaccination implementation plans, communication strategies, and training for health workers[5].
Despite these advancements, challenges persist. The distribution, access, and acceptance of the vaccine in affected regions remain significant hurdles. Concerted efforts and resources are necessary to ensure the widespread implementation and maximize the impact of the R21/Matrix-M vaccine in eradicating malaria[2].
In addition to the R21/Matrix-M vaccine, scientists are exploring other innovative approaches. Researchers from Heidelberg University, the Centre for Infectious Diseases at Heidelberg University Hospital, and the German Center for Infection Research (DZIF) have developed a new vaccine using genetically modified malaria parasites. These parasites develop normally in mosquitoes but at a significantly slower rate in mice, allowing the animals' immune system to fight them effectively. This approach has shown promise in animal trials, forming an immune memory that protects against severe symptoms during subsequent malaria infections[1].
The fight against malaria is complex, with regional variations of the pathogen, genetic differences in affected populations, co-infections with other pathogens, and increasing resistance to available drugs. However, with the introduction of new vaccines like R21/Matrix-M and ongoing research into novel vaccination procedures, there is renewed optimism in the global effort to combat this deadly disease[4]. -
In the ongoing global effort to combat malaria, several significant developments have emerged recently, particularly focusing on the advancement and implementation of malaria vaccines.
One of the most notable updates comes from the recent introduction of the R21/Matrix-M malaria vaccine into routine immunization programs. The Central African Republic (CAR) has become the fourth country to incorporate this vaccine into its Expanded Programme on Immunization (EPI), following countries like Côte d'Ivoire. This move is hailed as a major step forward in preventing malaria and protecting children's lives. In May 2024, CAR received 163,800 doses of the R21 vaccine, which are being rolled out to all eligible children. According to Meritxell Relaño, UNICEF Representative in CAR, the introduction of this vaccine is expected to significantly reduce early child deaths and strengthen the fight against malaria, a major cause of disease and death in children[5].
The R21/Matrix-M vaccine has garnered significant attention due to its high efficacy and safety profile. A phase III trial published in February 2024 in The Lancet demonstrated the vaccine's unprecedented safety, efficacy, and cost-effectiveness. The World Health Organization (WHO) has endorsed this vaccine, marking a significant advancement in the global fight against malaria. The vaccine has shown high efficacy in highly seasonal malaria settings and good efficacy in low-to-moderate endemicity settings when administered just before the transmission season[2][3].
Despite these promising developments, challenges such as vaccine distribution, access, and acceptance in affected regions remain significant hurdles. Concerted efforts and resources are necessary to ensure the widespread implementation and maximize the impact of the R21/Matrix-M vaccine in eradicating malaria[2].
In addition to vaccine advancements, the scientific community is also focusing on other aspects of malaria research. The 9th International Conference on Plasmodium vivax Research (ICPvR) 2025, held from February 12 to 14 in Puducherry, India, brought together leading experts to discuss the latest advancements in P. vivax research. The conference aimed to address critical knowledge gaps and promote collaborative efforts toward the elimination of P. vivax malaria. Key thematic sessions included epidemiological profiles, new tools in P. vivax biology, recent advances in P. vivax studies, and the impact of digital tools and climate change[1].
These combined efforts – from the implementation of new vaccines to the ongoing research and international collaborations – underscore the commitment to eradicating malaria. As global health leaders and organizations continue to work together, there is growing optimism about the potential to significantly reduce malaria cases and ultimately achieve a world free from this deadly disease. -
In recent developments, the fight against malaria has seen significant advancements, particularly in the realm of vaccine research and implementation.
### Recent Malaria Cases in the US
Although malaria was eliminated in the United States by 1951, a recent health advisory from the U.S. Centers for Disease Control and Prevention (CDC) reported that five people contracted malaria on U.S. soil without traveling abroad. This marks the first time since 2003 that such cases have occurred. The affected individuals, four in Sarasota County, Florida, and one in Cameron County, Texas, were infected with *Plasmodium vivax*, a less deadly form of the parasite compared to *P. falciparum*. All patients received treatment and are improving. This incident highlights the ongoing risk of malaria introduction through infected travelers or mosquitoes, even in areas where the disease has been eradicated[1].
### Malaria Vaccine Breakthroughs
On the global front, malaria vaccine development has made substantial progress. In 2021, the World Health Organization (WHO) approved the RTS,S (Mosquirix) vaccine for use in children, following successful pilot programs in Ghana, Kenya, and Malawi. This vaccine, developed by GlaxoSmithKline, targets *P. falciparum*, the most deadly malaria parasite. Ghana and Nigeria have been at the forefront of approving and implementing this vaccine, with Nigeria being the most affected country by malaria, accounting for over 30% of global malaria deaths[2].
More recently, a new malaria vaccine, R21, developed by the University of Oxford, has shown promising results with an efficacy of up to 80%. Ghana has officially approved the R21 vaccine for children aged between five months and three years, and Nigeria has granted provisional approval. This vaccine is seen as a significant tool in reducing malaria mortality, especially among children, and is expected to contribute to the long-term goal of malaria eradication[2][3].
### Ongoing Research and Funding
In the latest update from the past few days, Ocean Biomedical has announced significant advancements in their malaria vaccine research. With new funding from the National Institutes of Health (NIH) and an expedited development pathway from the FDA, the company is moving forward with innovative vaccine candidates. These candidates, based on a novel protein identified on the surface of malaria-infected red blood cells, aim to block the parasite's entry and exit from red blood cells. The use of lipid-encapsulated mRNA technology could facilitate faster transition to human trials, potentially starting as early as the fourth quarter of 2025[5].
### Global Efforts and Challenges
The rollout of malaria vaccines, while promising, faces several challenges, including funding and distribution. The WHO and other global health organizations are working to secure financial resources to ensure these vaccines reach the most affected populations. Despite these challenges, the demand and acceptability of malaria vaccines have been high in pilot programs, indicating a strong foundation for broader implementation[2][3].
In summary, the fight against malaria is intensifying with new vaccine approvals, ongoing research, and global efforts to ensure vaccine accessibility. While recent cases in the U.S. highlight the persistent risk of malaria, the advancements in vaccine technology and implementation offer hope for reducing the disease's impact, especially in the most affected regions. -
In the ongoing fight against malaria, several recent developments have marked significant strides in vaccine research and policy guidance.
Over the past few months, but notably highlighted in recent reports, a new malaria vaccine has shown promising results in clinical trials. Researchers at Leiden University Medical Center and Radboud University Medical Center in the Netherlands have demonstrated the safety and efficacy of a late-liver-stage attenuated malaria parasite vaccine, known as GA2. This vaccine involves immunization with a genetically modified Plasmodium falciparum parasite that develops further within liver cells, exposing the immune system to a broader range of parasite antigens. In a small clinical trial, GA2 induced a favorable immune response and provided protective efficacy against malaria infection in 89% of the participants, compared to 13% in the control group and none in the placebo group[2].
In addition to this breakthrough, other vaccine development efforts are also gaining momentum. Ocean Biomedical, a biopharma company, has recently received significant funding from the National Institutes of Health (NIH) to advance their malaria vaccine research. Led by Dr. Jonathan Kurtis, the team has identified a unique protein called glutamic acid-rich protein (GARP) on the surface of malaria-infected red blood cells, which children who naturally resist severe malaria have developed antibodies against. This discovery is pivotal in developing new vaccine candidates, and with the support of NIH grants, the team is now testing these candidates in non-human primates. The FDA's new guidance on lipid-encapsulated vaccines could expedite the transition to human trials, potentially as early as the fourth quarter of 2025[5].
Current malaria vaccines, such as RTS,S and its second-in-class variant R21/Matrix-M, have already shown substantial efficacy. These vaccines reduce uncomplicated malaria by around 40%, severe malaria by 30%, and all-cause mortality by 13% in children living in moderate to high malaria transmission areas. The World Health Organization (WHO) has recommended these vaccines, and they are expected to benefit all children in malaria-endemic areas[3].
The WHO's Malaria Policy Advisory Group (MPAG) continues to play a crucial role in guiding malaria control and elimination strategies. The group, comprising global experts, convenes regularly to review updates and provide guidance on thematic areas related to malaria. Recent meetings have focused on addressing the high prevalence of pfhrp2/3 gene deletions in the Horn of Africa and beyond, as well as reconsidering the formulation of malaria policy guidance[1].
These collective efforts underscore the urgent need for more effective and durable vaccination strategies against malaria, a disease that still poses a significant global health challenge, particularly in sub-Saharan Africa and parts of Asia and Latin America. With ongoing research and new funding, there is renewed hope for a transformative impact on global health in the fight against malaria. -
In the ongoing battle against malaria, several recent developments have brought new hope and advancements in the fight against this debilitating disease.
### Malaria Vaccine Progress
Over the past few days, significant updates have emerged regarding malaria vaccine research. One of the notable developments comes from Ocean Biomedical, which has announced substantial progress in their malaria vaccine research. With new funding from the National Institutes of Health (NIH) and an expedited development pathway facilitated by the U.S. Food and Drug Administration (FDA), Ocean Biomedical is advancing its innovative approach to malaria vaccination.
Dr. Jonathan Kurtis and his team have identified a unique protein, glutamic acid-rich protein (GARP), on the surface of malaria-infected red blood cells. Children who naturally resist severe malaria have been found to develop antibodies against this protein. This discovery has paved the way for testing three vaccine candidates in non-human primates, aiming to block the malaria parasite’s ability to enter and exit red blood cells. The use of lipid-encapsulated messenger ribonucleic acid (mRNA) technology as a delivery mechanism is also being explored, potentially allowing for human trials as early as the fourth quarter of 2025[5].
### Clinical Trials and Efficacy
In another significant development, researchers at Leiden University Medical Center and Radboud University Medical Center in the Netherlands have reported promising results from a clinical trial of a new malaria vaccine. The vaccine, known as GA2, involves a genetically modified *Plasmodium falciparum* parasite and has shown high protective efficacy against malaria infection. In the trial, immunization with GA2 induced a favorable immune response, providing protective efficacy in eight of nine participants, compared to much lower efficacy in the control groups. This approach, using whole-sporozoite vaccination with live-attenuated parasites, may enhance immunity by exposing the immune system to a broader array of antigens[2].
### WHO Recommendations and Rollout
The World Health Organization (WHO) has been actively involved in promoting malaria vaccines. Since October 2021, WHO has recommended the broad use of the RTS,S/AS01 malaria vaccine among children living in regions with moderate to high *P. falciparum* malaria transmission. In October 2023, WHO recommended a second safe and effective malaria vaccine, R21/Matrix-M. These vaccines are being rolled out in routine childhood immunization programs across Africa and are expected to save tens of thousands of young lives every year. The vaccines are most effective when introduced alongside other WHO-recommended malaria interventions such as bed nets and chemoprophylaxis[1][3].
### Global Impact and Challenges
Despite these advancements, malaria remains a significant global health challenge, particularly in sub-Saharan Africa. According to the latest World malaria report, there were 263 million cases of malaria in 2023, resulting in 597,000 deaths. The WHO African Region carries a disproportionately high share of the global malaria burden, with children under 5 years of age accounting for about 76% of all malaria deaths in the region[1].
The ongoing efforts to develop and distribute effective malaria vaccines are crucial in the fight against this disease. However, challenges such as emerging resistance to insecticides among *Anopheles* mosquitoes and antimalarial drug resistance continue to pose significant hurdles. Regular monitoring of antimalarial drug efficacy and the development of new strategies are essential to maintain progress in malaria control and elimination[1]. -
In the ongoing battle against malaria, several recent developments have marked significant progress, particularly in the realm of vaccine research and implementation.
One of the most promising updates comes from Ocean Biomedical, which has announced substantial advancements in their malaria vaccine research. With new funding from the National Institutes of Health (NIH) and an expedited development pathway from the U.S. Food and Drug Administration (FDA), the team led by Dr. Jonathan Kurtis is making strides in developing a novel malaria vaccine. This vaccine targets a unique protein called glutamic acid-rich protein (GARP) on the surface of malaria-infected red blood cells, which children who naturally resist severe malaria have been found to develop antibodies against. The research, supported by a $4.6 million non-governmental grant and an additional $3.5 million NIH grant, is currently testing three vaccine candidates in non-human primates and may initiate human trials as early as the fourth quarter of 2025[2].
In addition to these vaccine developments, recent studies have highlighted other critical aspects of malaria control. For instance, researchers have discovered that mosquitoes can survive prolonged droughts by relying on blood consumption, which explains why rates of mosquito-borne illnesses do not always decline during dry periods. This insight underscores the need for consistent and robust vector control measures, such as insecticide-treated nets and indoor residual spraying, even in times of drought[1].
The World Health Organization (WHO) has also been at the forefront of malaria vaccine implementation. The WHO has recommended the broad use of the RTS,S/AS01 malaria vaccine among children in regions with moderate to high malaria transmission. Recently, the WHO endorsed a second vaccine, R21/Matrix-M, which has shown high efficacy in highly seasonal malaria settings and good efficacy in low-to-moderate endemicity settings. These vaccines are being rolled out in routine childhood immunization programs across Africa, with the potential to save tens of thousands of young lives annually[3][5].
The distribution of these vaccines is part of a larger effort to combat malaria. For example, 18 million doses of the RTS,S/AS01 vaccine have been allocated to 12 African countries for the 2023-2025 period. Countries such as Ghana, Kenya, and Malawi will continue vaccinations in pilot areas, while new introductions are planned in Benin, Burkina Faso, Burundi, Cameroon, Democratic Republic of the Congo, Liberia, Niger, Sierra Leone, and Uganda. This rollout is a critical step in reducing the high mortality rate caused by malaria, which claims nearly half a million children under the age of 5 each year in Africa[5].
These advancements in vaccine research and implementation, coupled with ongoing efforts in vector control and drug resistance monitoring, represent a multifaceted approach to tackling the devastating impact of malaria globally. As new technologies and strategies emerge, there is growing hope for a future where malaria is more effectively controlled and its toll on human lives significantly reduced. -
In the ongoing battle against malaria, several significant developments have emerged in recent days, highlighting both the challenges and the promising advancements in combating this debilitating disease.
In Kogi State, Nigeria, the government has launched the 2025 Seasonal Malaria Chemoprevention (SMC) program, a crucial initiative aimed at preventing malaria in children during the peak transmission season, which typically runs from June to October. This program involves the monthly administration of life-saving anti-malaria drugs to children aged 3-59 months. During a stakeholder meeting in Lokoja, key officials emphasized the importance of stakeholders’ commitment, collaboration, and effective data management to ensure the program's success. The meeting addressed past challenges such as stockouts of Rapid Diagnostic Tests and Artemisinin-based Combination Therapies, diversion of antimalarial drugs, and data quality issues. To mitigate these, the state government has outlined interventions including improved access to antimalarial drugs, enhanced monitoring and supervision, and data quality improvement[1].
On the vaccine front, Ocean Biomedical has made substantial progress in malaria vaccine research. As of January 29, 2025, the company announced that it had received significant funding from the National Institutes of Health (NIH) to advance its groundbreaking malaria vaccine research. Dr. Jonathan Kurtis and his team have identified a unique protein, glutamic acid-rich protein (GARP), on the surface of malaria-infected red blood cells, which children who naturally resist severe malaria have developed antibodies against. With this discovery, the team is now testing three vaccine candidates in non-human primates, utilizing lipid-encapsulated messenger ribonucleic acid (mRNA) technology. The FDA's new guidance on lipid-encapsulated vaccines could expedite the transition to first-in-human trials, potentially as early as the fourth quarter of 2025[2].
These developments align with broader global efforts to combat malaria. Currently, two malaria vaccines are recommended for use in children living in moderate to high malaria transmission areas. These vaccines reduce uncomplicated malaria by about 40%, severe malaria by 30%, and all-cause mortality by 13%. The World Health Organization's recent recommendation of the R21/Matrix-M vaccine has also been significant, showing high efficacy in highly seasonal malaria settings and good efficacy in age-based administration in low-to-moderate endemicity settings[3].
Innovative approaches continue to emerge, such as genetically modifying malaria parasites to trigger immunity rather than disease. Scientists have developed parasites like GA1 and GA2, which, when transmitted through mosquito bites, can induce strong immune protection. In a recent trial, participants exposed to GA2 parasites showed an immune protection of 89%, highlighting a promising new avenue in malaria prevention[5].
These recent advancements underscore the multifaceted approach being taken to combat malaria, from chemoprevention programs to innovative vaccine research and genetic modifications. As these efforts continue to evolve, there is growing hope for a significant reduction in malaria cases and deaths globally. -
In the ongoing battle against malaria, a disease that claims the lives of over 500,000 children annually in sub-Saharan Africa, recent developments in vaccine research and deployment offer promising hope.
One of the most significant updates comes from Ocean Biomedical, which has announced substantial progress in its malaria vaccine research. With new funding from the National Institutes of Health (NIH) and an expedited development pathway facilitated by the U.S. Food and Drug Administration (FDA), the company is advancing its innovative approach to malaria vaccination. Dr. Jonathan Kurtis and his team have identified a unique protein, glutamic acid-rich protein (GARP), on the surface of malaria-infected red blood cells, which children who naturally resist severe malaria have developed antibodies against. This discovery has led to the development of three vaccine candidates currently being tested in non-human primates, aiming to block the malaria parasite’s ability to enter and exit red blood cells. The use of lipid-encapsulated messenger ribonucleic acid (mRNA) technology as a delivery mechanism is also being explored, with potential human trials anticipated as early as the fourth quarter of 2025[2].
In addition to these advancements, a novel class of anti-malaria antibodies has been discovered by researchers at the National Institutes of Health (NIH). Published in the journal *Science*, this study reveals antibodies that bind to previously untargeted portions of the malaria parasite, offering a new tool in the fight against the disease. The most potent of these antibodies, named MAD21-101, has shown significant protection against *Plasmodium falciparum* infection in animal models. These antibodies target regions of the parasite not included in current malaria vaccines, providing a promising avenue for future prevention methods[4].
The World Health Organization (WHO) has been at the forefront of promoting existing malaria vaccines, particularly the RTS,S/AS01 and the recently recommended R21/Matrix-M vaccines. These vaccines have been shown to significantly reduce malaria cases and deaths among young children in regions with moderate to high malaria transmission. The R21 vaccine, in particular, is expected to have a high impact due to its ease and cost-effectiveness of production, with the Serum Institute of India capable of manufacturing over 100 million doses per year. This could potentially vaccinate 40 million children and save roughly 240,000 lives annually[3][5].
Despite these advancements, challenges remain in the deployment of these vaccines. The WHO has faced limitations in supply, with only 18 million RTS,S doses available for 2023 to 2025, which is insufficient to meet the demand for the approximately 80 million children at risk in Africa. However, the WHO and global health alliances are working to expedite the process, utilizing strategies such as emergency use listing to accelerate vaccine distribution, a method successfully employed during the COVID-19 pandemic[5].
In summary, the fight against malaria is seeing significant strides with new vaccine candidates, innovative delivery mechanisms, and the continued rollout of existing vaccines. While logistical challenges persist, the collective efforts of researchers, health organizations, and manufacturers are poised to make a substantial impact in reducing the devastating burden of malaria globally. -
In the ongoing battle against malaria, significant advancements have been made, particularly with the recent developments and implementations of malaria vaccines. As of the latest updates, two malaria vaccines, RTS,S/AS01 and R21/Matrix-M, have been recommended by the World Health Organization (WHO) for the prevention of _Plasmodium falciparum_ malaria in children living in areas of moderate to high transmission.
The WHO updated its recommendation in October 2023, emphasizing the use of these vaccines to protect children, who are particularly vulnerable to malaria. In 2023, malaria claimed the lives of approximately 432,000 African children, highlighting the urgent need for effective preventive measures. The pilot introduction of the RTS,S vaccine in Ghana, Kenya, and Malawi demonstrated a substantial public health impact, including a 13% drop in mortality among children eligible for vaccination and a significant reduction in hospitalizations for severe malaria[1].
The R21/Matrix-M vaccine, co-developed by the University of Oxford and the Serum Institute of India, has also shown promising results. Phase III trials published in February 2024 in _The Lancet_ revealed unprecedented safety, efficacy, and cost-effectiveness. This vaccine is the first to achieve the WHO-specified 75% efficacy goal, particularly in highly seasonal malaria settings when administered just before the transmission season[2][5].
As of December 2024, 17 countries in Africa have introduced these malaria vaccines into their routine childhood immunization programs. The Central African Republic is among the latest to integrate the R21/Matrix-M vaccine into its Expanded Programme on Immunization (EPI), aiming to vaccinate around 200,000 children. This rollout is supported by WHO, UNICEF, and Gavi, the Vaccine Alliance, which are also assisting in developing vaccination implementation plans, communication strategies, and training for health workers[4].
Both vaccines have been prequalified by WHO, ensuring their safety and quality. The RTS,S vaccine was prequalified in July 2022, and the R21 vaccine received prequalification in December 2023. The availability of these two vaccines is expected to meet the high demand, with the capacity to manufacture 100-200 million doses of the R21/Matrix-M vaccine annually[1][2].
The widespread implementation of these vaccines is anticipated to save tens of thousands of young lives every year. Modelling estimates suggest that scaling up these vaccines to all Gavi-eligible countries could prevent up to half a million child deaths over 12 years. Despite the promising efficacy, challenges such as vaccine distribution, access, and acceptance in affected regions remain significant hurdles that need to be addressed[1][5].
In conclusion, the recent advancements in malaria vaccines represent a significant breakthrough in the global fight against malaria. With continued support from international partners and concerted efforts to ensure widespread implementation, these vaccines hold the potential to redefine malaria prevention and save countless lives in the years to come. -
In the ongoing battle against malaria, significant advancements have been made, particularly with the development and implementation of malaria vaccines. As of the latest updates, two malaria vaccines have garnered substantial attention and approval from global health authorities.
The World Health Organization (WHO) has recommended the programmatic use of malaria vaccines, specifically Mosquirix™ (RTS,S/AS01) and R21/Matrix-M™, for preventing _Plasmodium falciparum_ malaria in children living in malaria-endemic areas. These vaccines were added to the WHO list of prequalified vaccines in 2024, and as of January 2025, 17 countries have introduced them through routine immunization[1].
The R21/Matrix-M vaccine, co-developed by the University of Oxford and the Serum Institute of India, has been hailed as a breakthrough. It is the first malaria vaccine to achieve the WHO-specified 75% efficacy goal. Phase III trial data published in _The Lancet_ in February 2024 highlighted the vaccine's unprecedented safety, efficacy, and cost-effectiveness. This vaccine is poised to manufacture 100-200 million doses annually, ensuring equitable access for vulnerable populations[2][5].
The WHO's revised guidelines for malaria, updated in November 2024, emphasize the importance of these vaccines. The organization estimates that the annual global demand for malaria vaccines will be 40–60 million doses by 2026 and 80–100 million doses annually by 2030[1].
In addition to these approved vaccines, several promising candidates are in various stages of development. The RH5.1/Matrix-M malaria vaccine, developed at the University of Oxford, targets blood-stage malaria and has shown a vaccine efficacy of 55% in phase 2b trials. This vaccine appears safe and highly immunogenic in African children, offering promising efficacy against clinical malaria[1].
Another notable development is the use of monoclonal antibodies for malaria prevention. A phase 2 study published in the _New England Journal of Medicine_ in April 2024 demonstrated that a single subcutaneous injection of the NIAID's experimental L9LS malaria monoclonal antibody offered up to 77% protection against _P. falciparum_ infection over six months. Another monoclonal antibody, VRC-MALMAB0100-00-AB, was found to be up to 88.2% effective at preventing infection over 24 weeks[1].
Furthermore, innovative technologies such as self-amplifying replicon RNA (repRNA) and lipid nanoparticle (LION™) are being explored for malaria vaccines. MalarVx, Inc. has licensed these technologies from HDT Bio, demonstrating their potential in preventing infections caused by _Plasmodium_ parasites[1].
While these advancements are significant, challenges such as vaccine distribution, access, and acceptance in affected regions remain. Concerted efforts and resources are necessary to ensure the widespread implementation and maximize the impact of these vaccines in eradicating malaria[5].
In summary, the recent progress in malaria vaccines marks a critical turning point in global health efforts to combat this deadly disease. With approved vaccines like Mosquirix™ and R21/Matrix-M™, and promising candidates in the pipeline, there is renewed hope for reducing the burden of malaria, especially among vulnerable populations in endemic areas. -
In the ongoing fight against malaria, recent developments have marked significant milestones in the quest for effective vaccination strategies. As of the latest updates, several advancements in malaria vaccines have been highlighted, particularly over the past few months, although specific news from the past two days is limited.
The World Health Organization (WHO) has been at the forefront of promoting malaria vaccines, with two vaccines, Mosquirix™ (RTS,S/AS01) and R21/Matrix-M™, recommended for use in children living in malaria-endemic areas. These vaccines were added to the WHO list of prequalified vaccines in 2024, and as of January 2025, 17 countries have introduced them through routine immunization programs[1][3].
The R21/Matrix-M vaccine, co-developed by the University of Oxford and the Serum Institute of India, has shown unprecedented safety, efficacy, and cost-effectiveness. It is the first malaria vaccine to achieve the WHO-specified 75% efficacy goal and has demonstrated high efficacy in both highly seasonal and low-to-moderate malaria transmission settings[2][3].
In addition to these approved vaccines, new candidates are showing promising results. The RH5.1/Matrix-M malaria vaccine, developed at the University of Oxford, targets the blood-stage of malaria and has shown a vaccine efficacy of 55% in phase 2b trials. This vaccine appears safe and highly immunogenic in African children, offering promising efficacy against clinical malaria[1].
Another innovative approach involves whole-sporozoite vaccination with live-attenuated parasites. A recent study published in _Nature Medicine_ highlighted the efficacy of genetically attenuated Pf∆mei2 parasites (GA2), which provided up to 90% protection against malaria infection in clinical trials. This single-dose vaccine has shown no breakthrough infections in participants and induces a robust immune response, making it a promising candidate for future widespread use[5].
Furthermore, monoclonal antibodies are also being explored as a preventive measure. A phase 2 study published in the _New England Journal of Medicine_ demonstrated that a single subcutaneous injection of the L9LS malaria monoclonal antibody offered up to 77% protection against _P. falciparum_ infection over six months. Another monoclonal antibody, VRC-MALMAB0100-00-AB, showed up to 88.2% effectiveness in preventing infection over 24 weeks[1].
These advancements underscore the growing arsenal of tools in the fight against malaria, a disease that still claims over 600,000 lives annually, predominantly among children under five. As research continues and more vaccines and treatments are developed, the global health community remains hopeful for a future where malaria can be significantly controlled or even eradicated. -
In the ongoing battle against malaria, recent developments have brought both urgency and hope to the forefront. Over the past two days, significant updates have emerged, particularly regarding the pursuit of an effective malaria vaccine.
Malaria remains a devastating global health challenge, especially in Africa, where it accounted for an estimated 94% of global malaria cases and 95% of malaria-related deaths in 2023. The disease claims the life of one child every minute in Africa, with 76% of lethal cases among children under the age of 5[1].
Despite these grim statistics, there have been notable advancements in malaria control efforts. Since 2000, targeted policies and investments have helped avert 2.2 billion cases and 12.7 million deaths worldwide. In 2023 alone, more than 177 million cases and 1 million deaths were estimated to have been averted globally, with 80% of averted cases and 94% of averted deaths occurring in the WHO African Region[1].
On the vaccine front, Ocean Biomedical has made substantial progress. The company's Scientific Co-founder, Dr. Jonathan Kurtis, and his team have received additional significant funding from the National Institutes of Health (NIH) to advance their groundbreaking malaria vaccine research. This funding includes a $3.5 million NIH grant secured in December 2024 to further identify vaccine targets to protect against severe malaria in children[2][4][5].
Dr. Kurtis' team has taken a novel approach by studying naturally occurring immune responses in children who have developed resistance to malaria. Through longitudinal studies, they identified a unique protein called glutamic acid-rich protein (GARP) on the surface of malaria-infected red blood cells. Children who naturally resisted severe malaria were found to have developed antibodies against GARP, paving the way for vaccine development[2][4][5].
With the support of a $4.6 million non-governmental Foundation grant, Dr. Kurtis' team is currently testing three vaccine candidates in non-human primates. These candidates aim to block the malaria parasite's ability to enter and exit red blood cells, utilizing lipid-encapsulated messenger ribonucleic acid (mRNA) technology as a delivery mechanism. The FDA's new guidance on lipid-encapsulated vaccines could facilitate a faster transition to first-in-human trials, potentially allowing Ocean Biomedical to initiate human trials as early as the fourth quarter of 2025[2][4][5].
In addition to these developments, existing malaria vaccines have shown promising results. The World Health Organization (WHO) has recommended two malaria vaccines for use in children living in moderate to high malaria transmission areas. These vaccines reduce uncomplicated malaria by about 40%, severe malaria by about 30%, and all-cause mortality by 13%. The WHO's recommendation of the R21/Matrix-M vaccine in 2023 is expected to ensure sufficient vaccine supply to benefit all children living in malaria-endemic areas[3].
While significant challenges such as funding gaps, poverty, climate change, and humanitarian emergencies continue to jeopardize progress, the recent advancements in malaria vaccine research offer a beacon of hope in the fight against this devastating disease. As the global community continues to invest in and advocate for malaria control efforts, the potential for a breakthrough malaria vaccine brings renewed optimism for a future where malaria is no longer a leading cause of death. -
In the ongoing fight against malaria, significant advancements have been made, particularly in the development and deployment of malaria vaccines. As of the latest updates, the World Health Organization (WHO) has reinforced its recommendations for the use of malaria vaccines to prevent _Plasmodium falciparum_ malaria in children living in endemic areas.
The WHO has prequalified and recommended two malaria vaccines: Mosquirix™ (RTS,S/AS01) and R21/Matrix-M™. Both vaccines have been shown to be safe and effective in preventing malaria in children, with the ability to reduce malaria cases by more than half during the first year after vaccination. A fourth dose given in the second year of life prolongs this protection, and when administered seasonally in areas of highly seasonal transmission, these vaccines can prevent around 75% of malaria episodes[3][4].
The R21/Matrix-M™ vaccine, co-developed by the University of Oxford and the Serum Institute of India, has recently been rolled out in several African countries. As of July 2024, 15 African countries, including Côte d’Ivoire, Ghana, Nigeria, Burkina Faso, and the Central African Republic, have introduced this vaccine, aiming to reach around 6.6 million children by 2025[5].
In addition to these existing vaccines, a breakthrough has been achieved with the development of the RH5.1/Matrix-M™ vaccine, which targets the blood-stage of malaria. This vaccine, developed at the University of Oxford, has shown promising safety and efficacy in early trials. In a clinical trial involving 360 children in Burkina Faso, the vaccine demonstrated 55% efficacy in preventing clinical malaria and over 80% efficacy in preventing severe cases. This new vaccine offers a vital second line of defense against malaria, complementing the existing liver-stage vaccines[2].
The global demand for malaria vaccines is expected to increase significantly, with the WHO estimating an annual demand of 40–60 million doses by 2026 and 80–100 million doses annually by 2030. To meet this demand, production capacities are being expanded. For instance, the technology transfer to the Bharat Biotech International Limited (BBIL) is expected to increase the supply and reduce the prices of the RTS,S/AS01 vaccine[4].
Furthermore, innovative technologies are being explored to enhance malaria vaccine development. In January 2025, MalarVx, Inc. licensed HDT Bio's proprietary self-amplifying replicon RNA (repRNA) and lipid nanoparticle (LION™) technologies for use in malaria vaccines, demonstrating potential in preventing infections caused by _Plasmodium_ parasites[1].
In another significant development, monoclonal antibodies have shown promising results in preventing malaria. A phase 2 study published in April 2024 demonstrated that a single subcutaneous injection of the NIAID's experimental L9LS malaria monoclonal antibody offered up to 77% protection against _P. falciparum_ infection over six months. Another monoclonal antibody, VRC-MALMAB0100-00-AB, was found to be up to 88.2% effective at preventing infection over 24 weeks[1].
These advancements underscore the concerted global effort to combat malaria, particularly in regions with the highest burden. As the WHO continues to update its guidelines and recommendations, the availability and effectiveness of these vaccines are expected to significantly impact public health, especially among vulnerable populations such as children in malaria-endemic areas. -
In recent days, the global health community has been grappling with a significant surge in malaria cases, particularly in regions with high transmission rates. In Namibia, health authorities have implemented emergency measures to combat a sharp increase in malaria infections. Between the start of the rainy season in December and January 19, 2025, Namibia reported 5,898 malaria cases, a substantial rise from the 3,979 cases recorded in the same period last year[1].
This surge underscores the ongoing challenge posed by malaria, a disease that still claims over a million lives annually, predominantly among children in Africa and Asia. The World Health Organization (WHO) has set an ambitious goal to develop an effective malaria vaccine by 2025, building on the lessons learned from the COVID-19 pandemic. The current vaccine, RTS,S, developed by GSK, has been a significant step forward but only prevents about 40% of infections and reduces severe malaria cases by around 30%[2][3].
A new vaccine, R21/Matrix-M, co-developed by the University of Oxford and the Serum Institute of India, has shown promising results. Endorsed by the WHO in 2023, this vaccine has demonstrated higher efficacy, especially in highly seasonal malaria settings. It has been shown to be safe, cost-effective, and highly effective when administered just before the transmission season. However, challenges such as vaccine distribution, access, and acceptance in affected regions remain significant hurdles[3][5].
The WHO's latest malaria report highlights the growing threat of climate change and the increasing number of malaria cases globally. In 2023, there were an estimated 263 million malaria cases and 597,000 related fatalities worldwide, representing an increase of about 11 million cases from 2022. The WHO African Region bears the heaviest burden of the disease, with countries like Burkina Faso, Cameroon, and the Democratic Republic of the Congo reporting high infection rates[4].
As efforts to develop and distribute effective malaria vaccines continue, the importance of integrated public health strategies cannot be overstated. These include the use of insecticide-treated nets, robust case management, and other control interventions. The global community remains committed to eradicating malaria, with organizations like the WHO and various health institutions working tirelessly to ensure the widespread implementation and maximum impact of these vaccines. Despite the progress, the fight against malaria is far from over, and sustained efforts are crucial to saving lives and reducing the disease's global burden. -
In the ongoing global effort to combat malaria, several recent developments have marked significant strides, particularly in the realm of vaccine development and implementation.
One of the most notable updates comes from the World Health Organization's (WHO) continued push for effective malaria vaccines. Despite the existence of vaccines like RTS,S, which was developed over 25 years ago and prevents only about 40% of uncomplicated malaria cases, the WHO is aiming to produce a more effective vaccine by 2025. This goal is driven by the need to address the over a million malaria-related deaths annually, mostly affecting children in Africa and Asia[2][3].
A recent breakthrough in this endeavor is the R21/Matrix-M vaccine, which has shown unprecedented safety, efficacy, and cost-effectiveness in phase III trials. The WHO endorsed this vaccine in 2023, highlighting its potential to significantly reduce malaria cases, especially in highly seasonal transmission settings. The R21/Matrix-M vaccine has demonstrated high efficacy when administered just before the transmission season and good efficacy in age-based administration in low-to-moderate endemicity settings[3][5].
On the ground, countries are actively integrating these vaccines into their public health strategies. Niger, for instance, has become the latest West African country to launch a large-scale malaria vaccination campaign using the RTS,S vaccine. This campaign, initiated in the southwestern city of Gaya, a hotspot for malaria, aims to lower the mortality rate in children, as malaria accounts for 19% of child deaths in Niger. The vaccine is estimated to be 75% effective in protecting against severe forms of malaria. Alongside vaccination, Niger will continue distributing free mosquito nets and administering preventive medication to children ahead of the wet season[4].
The rollout of malaria vaccines is not limited to Niger; other West African countries such as Cameroon, Ivory Coast, Ghana, Nigeria, Burkina Faso, and the Central African Republic have also authorized the use of RTS,S and R21/Matrix-M vaccines. These efforts underscore the concerted global response to malaria, combining vaccination with other control interventions like insecticide-treated nets (ITNs) and case management to maximize impact[3][4].
While these advancements are promising, challenges such as vaccine distribution, access, and acceptance in affected regions remain significant hurdles. Ensuring widespread implementation and maximizing the impact of these vaccines will require continued resources and efforts from global health authorities and local governments[5].
In summary, the fight against malaria has seen substantial progress with the development and deployment of more effective vaccines like R21/Matrix-M and the ongoing vaccination campaigns in various African countries. As the world moves closer to the WHO's goal of an effective malaria vaccine by 2025, these recent developments offer hope for a future where malaria's deadly grip can be significantly loosened. -
In recent developments, the United States has seen a troubling resurgence of malaria, a disease that had not been locally transmitted within the country for two decades. As of the last update, five confirmed cases of locally acquired malaria have been reported in Florida and Texas, prompting concerns and heightened vigilance among health officials.
According to ABC News, these cases are significant because they indicate local transmission via _Anopheles_ mosquitoes, rather than being linked to travel. While the number of cases is still small and the overall risk to the population remains low, the fact that malaria is reappearing in the U.S. is alarming. Experts attribute this resurgence partly to climate change, which is increasing the number of days mosquitoes are active and shortening the time it takes for them to develop from eggs to adults. This accelerated cycle can lead to a quicker buildup of disease-carrying mosquitoes in the environment[1].
Symptoms of malaria include fever, chills, body aches, headache, fatigue, and sometimes gastrointestinal symptoms. These symptoms can appear 10 to 15 days after infection and can be severe, necessitating immediate medical evaluation and treatment. The current cases in Florida and Texas are responding well to treatment, but the CDC has issued warnings for urgent evaluation of anyone exhibiting these symptoms, especially in the affected areas[1][4].
On the global front, significant progress has been made in the fight against malaria, particularly with the development and deployment of new malaria vaccines. In 2021, the World Health Organization (WHO) approved the RTS,S/AS01 malaria vaccine, developed by GlaxoSmithKline, for use in children in regions with moderate to high malaria transmission. This vaccine has been shown to reduce uncomplicated malaria by about 40%, severe malaria by 30%, and all-cause mortality by 13%[3][4].
More recently, Ghana and Nigeria have approved a new malaria vaccine, R21/Matrix-M, developed by the University of Oxford. This vaccine has demonstrated an efficacy of up to 80% in clinical trials and is expected to make a major impact on malaria mortality in children. The R21 vaccine is seen as a breakthrough, with the potential to save tens of thousands of young lives annually and contribute significantly to the long-term goal of malaria eradication[2][4].
The WHO has recommended the use of these vaccines in conjunction with other control interventions such as insecticide-treated nets (ITNs) and indoor residual spraying (IRS) to maximize their impact. Despite these advancements, challenges remain, including the emergence of insecticide-resistant mosquito species like _Anopheles stephensi_, which is expanding its range in Africa[4].
As the global community continues to battle malaria, the introduction of these new vaccines marks a significant step forward. With ongoing efforts to improve vaccine efficacy, manufacturing, and rollout, there is renewed hope in the fight against this deadly disease. The WHO's global technical strategy aims to reduce malaria case incidence and mortality rates by at least 90% by 2030, and the new vaccines are crucial in achieving these ambitious targets[4]. - Visa fler
