Ending malaria once and for all requires more than a vaccine

When the World Health Organization announced early last month that it was recommending the widespread use of a malaria vaccine for children in Africa, the global response was jubilant. The announcement was described as “historic,” a “breakthrough,” “game-changing” and “a triumph for global public health.”

And appropriately so. The availability of the world’s first malaria vaccine represents a huge step toward ending a disease that has ravaged human civilization for at least as long as recorded human history. This moment is the hard-won culmination of more than three decades of the vaccine’s development, including critical U.S.-funded research and support. So there is good reason to celebrate.

With an efficacy of just over 30 percent, the vaccine (produced by GlaxoSmithKline) will likely save tens of thousands of lives every year. But it is only in combination with other tools that the vaccine has the potential to defeat malaria for good. In fact, a recent study found that combining the vaccine with antimalarial drugs reduces the risk of severe malaria in children up to 70 percent. 

With the World Series just ending, think of this vaccine as a once-in-a-generation pitcher who joins a team. It can deliver crucial outs, post scoreless innings and dramatically improve the team’s chances of winning the series, but it can’t win a championship alone.

Over the past two decades, a roster of proven, cost-effective tools — insecticides and nets, rapid diagnostic tests and life-saving treatments — have, according to the 2020 World Malaria Report, prevented 1.5 billion malaria infections and saved 7.6 million lives, halting the spread of malaria in 26 countries since 2000.

Yet, progress is not universal. In 2019 alone, malaria infected 229 million people and killed 409,000, two-thirds of whom were children under the age of five. A child still dies every two minutes from a mosquito bite. 

Fortunately, on the same day that the malaria vaccine was announced, the U.S. President’s Malaria Initiative (PMI) unveiled a bold new plan to save 4 million more lives and prevent more than 1 billion more cases in the next five years through its work with 27 partner countries, which together represent 80 percent of the remaining malaria burden. 

To realize the promise of the vaccine, we must invest in the things that rarely make headlines. This includes equipping and training frontline health workers in the world’s most remote communities to distribute insecticide-treated nets and preventative treatment for infants and pregnant women. It means investing in better supply chains to deliver life-saving malaria drugs and rapid diagnostics when and where they’re needed most. This is where PMI excels, and it is why the program has made us a global leader in the fight against malaria these past 15 years.

Investing in malaria programs also happens to be the fastest and most cost-effective way to strengthen critical disease surveillance, labs, fever case identification and data capabilities needed to not only end malaria but also defeat COVID-19 and prevent the next pandemic before it starts. 

With the addition of the vaccine — and other new tools, developed by the National Institutes of Health and our partners — we have an exciting opportunity to end humanity’s oldest and deadliest pandemic once and for all. 

U.S. global leadership is needed now, more than ever. It is imperative for us to seize the opportunity of new malaria technologies and expand the reach of PMI. Congress should increase PMI’s appropriations from $770 million now to $1 billion by fiscal year 2023 and to at least $2 billion over the next eight years. House appropriators have called for a commendable $820 million for fiscal year 2022, a high watermark with the Senate calling for a similar level. We also urge Congress to continue its strong, bipartisan support of the Global Fund to Fight Aids, Tuberculosis, and Malaria in the years ahead.

American leadership can put us on a path to ending suffering and death for far too many people — especially the poorest women and children on the planet — and help ensure malaria-affected countries can realize their economic and social potential. Yes, let’s celebrate the achievement of the new malaria vaccine, but let’s not let the opportunity it presents go to waste.

Martin Edlund is a founding member and CEO of Malaria No More, a nonprofit advocacy organization that envisions a world where no one dies from a mosquito bite and is working toward ending malaria within a generation.