Malaria vaccines are being rolled out across Africa.Credit: Getty
As malaria remains one of Africa’s most persistent public health threats, 2025 is poised to become a turning point in the fight against the disease, with numerous African countries set to expand vaccine coverage at unprecedented levels.
Uganda is at the forefront, launching Africa’s largest malaria vaccine rollout to date. On March 7, 2025, the country’s Ministry of Health, with support from Gavi the Vaccine Alliance, WHO, and UNICEF, began distributing 2.278 million doses of the R21/Matrix-M vaccine to 105 districts. The campaign targets 1.1 million children under the age of two, with the four-dose regimen administered at 6, 7, 8, and 18 months. The vaccine is being integrated into Uganda’s routine immunisation program, complementing existing malaria control efforts like insecticide-treated nets and indoor spraying.
Zambia is also preparing for a national rollout, aiming to reach children under two across all provinces beginning in the third quarter of 2025. Similarly, Burundi officially launched the RTS, S/AS01 (Mosquirix) vaccine in March 2025, now part of its routine immunisation schedule for children under five.
Other countries including Ethiopia, Guinea, Guinea-Bissau, Mali, and Togo are preparing for subnational introductions with phased implementation expected later in the year.
Scott Gordon, Head of the Malaria Programme at Gavi, says “we’re supporting malaria vaccine introduction in 20 countries, marking a coordinated continental effort.”
The two vaccines in use, RTS,S and R21, offer promising protection, particularly when used alongside existing malaria interventions. RTS,S shows efficacy up to 72%1 when used seasonally, while R21 has demonstrated up to 75% efficacy in trials2. Both vaccines follow a four-dose schedule beginning in infancy. Several countries, including Burkina Faso, Ghana, Kenya, and Nigeria, have already begun nationwide distribution, with more set to follow later in 2025. Backed by the World Health Organization and supported by Gavi, UNICEF, and other global health partners, the rollout marks a major step toward reducing the estimated 500,000 annual malaria deaths in sub-Saharan Africa, most of them children under five.
However, logistical challenges remain. Maintaining cold-chain storage, training healthcare workers, and ensuring adherence to vaccination timelines are critical for program success. Community engagement also plays a vital role in dispelling myths and boosting vaccine uptake.
Notably, pilot programs in Ghana, Kenya, and Malawi have proven the effectiveness and safety of malaria vaccines, leading to significant reductions in severe cases and child mortality.
“We’ve seen really substantial public health impact in the pilot countries, reductions in severe malaria and child deaths,” Gordon says. “It really validates the safety and effectiveness of the vaccine.”
The future of these programmes is now in after US Health Secretary Robert F. Kennedy Jr. announced that the United States would halt funding to Gavi, The Vaccine Alliance, citing transparency and accountability concerns. In response, Gavi defended its safety record and reaffirmed that all supported vaccines follow WHO recommendations. “Gavi’s utmost concern is the health and safety of children,” the alliance said in a statement. It underscored that decisions are guided by WHO’s Strategic Advisory Group of Experts on Immunization (SAGE).
“We’ve demonstrated the impact of our vaccines over Gavi’s 25-year history… We continue to work very closely with WHO and its Strategic Advisory Group of Experts to guide our vaccine decisions,” says Gordon.
“Our concern is how we raise the usual resources so we can continue to expand access to life-saving vaccines like malaria. But we’re really happy with some of the signals of support that we have seen, even with the US government stepping back from some of its international commitments.”
He notes that, for now, operations remain stable: “There has been no direct impact from the US government decision. The rollout continues as planned, and we haven’t had to adjust any support for the countries.”
Kenya, one of the original pilot countries where the vaccine’s safety and impact were first demonstrated, continues its rollout without disruption. As the country’s economy grows, it is also being looked to as a leader in transitioning toward domestic vaccine financing, signalling a shift toward long-term sustainability.
In the long term, Gavi is working with countries to make malaria vaccine programmes financially sustainable. “For example, manufacturers have agreed to progressively reduce the price of malaria vaccines over time,” Gordon explains. “We want countries to eventually integrate vaccine procurement into their own health budgets, especially as some like Kenya become more economically developed.”
“The announcement introduces uncertainty and the full extent of its impact will need to be determined. In the interim, the existing malaria vaccine rollout in Uganda is unlikely to be affected. As far as WHO is aware, this rollout is still on track,” Kasonde Mwinga, WHO Representative to Uganda says.
She explains that the introduction is being implemented in phases, starting with districts facing a moderate to high malaria burden. Although the initial stage is proceeding as planned, Mwinga warned that resource limitations could arise when extending coverage to 41 additional low-burden districts. “That’s where we may begin to see pressure if funding shortfalls materialise,” she says. Nonetheless, she expressed hope that the resources secured through Gavi 6.0 will prioritise countries already in the implementation phase.
To sustain progress, Uganda is supported by a five-year Gavi Health System Strengthening (HSS) grant, which backs healthcare worker training and broader capacity-building initiatives. Mwinga confirmed that vaccine supply for districts currently covered by the program remains stable, thanks to existing commitments from Gavi.
Mwinga added, “Encouragingly, at Gavi’s high-level pledging summit during the last week of June 2025 in Brussels, a record number of donors pledged towards Gavi, securing more than US$9 billion towards a target budget of US$11.9 billion to fund GAVI 6.0. This is a great milestone for the next five-year strategic plan for Gavi.”
However, the Uganda Virus Institute is already being affected by the cuts, according to its director Pontiano Kaleebu “We had a programme on vaccine research, virology, and how to induce or develop vaccines, which has been cut because the US discontinued funding.”
However, Kaleebu clarified that these cuts are related to research and development efforts, not the national malaria vaccine rollout itself. The immunisation programme continues under existing Gavi support.
Nicaise Ndembi, Deputy Director of the International Vaccine Institute Africa Regional Office, has warned that the recent US decision to halt funding is a wake-up call for Africa to reassess its health sovereignty. While concerns have largely centred on malaria, he stresses that “it is not only malaria vaccine delivery or malaria immunisation that’s going to be affected. All routine vaccines – because they are part of an integrated package – will be affected if these funding cuts take hold.”
Ndembi called the situation a pivotal moment. “The global architecture cannot rest on the shoulder of a single country. The US doesn’t have malaria. Why should they fix our problem?” Instead, he argued, the responsibility lies with African governments. “Our own health and finance ministers must find a solution. We’ve relied too long on overseas development assistance.”
As vaccine rollouts accelerate across the continent, experts emphasise an integrated approach combining immunisation with proven tools like treated bed nets and antimalarials as essential to reducing the malaria burden.
Gordon emphasises the need for a united effort to sustain vaccine progress, stating: “We want to see companies and governments stepping up to support this life-saving vaccine for children. While some international donors are adjusting their commitments, many countries are rising to the challenge, using their own resources to ensure access. It’s crucial that African nations keep leading this cause and invest in their health systems, so we can work towards eliminating malaria together.”
The momentum in 2025 signals not just a new chapter in malaria control but a potential game-changer in saving millions of young lives across Africa. According to the WHO, the introduction of malaria vaccines this year marks a pivotal moment in the fight against the disease. When combined with existing tools, these vaccines could reduce clinical malaria cases by more than 90% in regions with high seasonal transmission.
As Kasonde Mwinga put it: “This vaccine is a game-changer, and together, we must ensure that every child receives it.”
