Uganda has launched its largest malaria vaccination campaign to date, marking a significant step in the country’s fight against malaria. The campaign introduces the R21 malaria vaccine, which has been adopted after a successful pilot in Kenya, Ghana, and Malawi. The vaccine has shown promising results, with evidence of a 13% reduction in all-cause mortality among children who received it during the pilot phase.
The R21 vaccine will be administered in four doses: at 6, 7, 8, and 18 months of age. Initially, the campaign will target 1.1 million children under the age of two, covering 105 high- and moderate-transmission districts across Uganda. Apac District, which has the highest number of mosquito bites per person globally, is among the first regions to roll out the vaccine. Uganda’s introduction of the vaccine makes it the 19th country in Africa to include malaria vaccination in its routine immunization schedule.
Malaria remains a leading cause of illness and death among young children in Uganda, accounting for up to 33% of all outpatient visits, 22% of hospital admissions, and 6% of deaths. Uganda was also among the top five African countries with the highest malaria burden in 2023, alongside Nigeria, the Democratic Republic of the Congo, Ethiopia, and Mozambique. Given the high transmission rates, the R21 vaccine is seen as a crucial tool in reducing the burden of malaria in the country.
The introduction of the R21 vaccine is expected to prevent at least 800 cases of severe malaria every day and alleviate the financial burden that families face due to the disease. Malaria remains a major challenge in Uganda’s healthcare system, with the government committed to reducing its impact on the population.
In 2019, Kenya began using the RTS,S malaria vaccine, which was the first malaria vaccine to be recommended by the World Health Organization (WHO). Both the RTS,S/AS01 and R21/Matrix-M vaccines have received prequalification and are recommended by WHO for malaria prevention in children. The successful roll-out of these vaccines in different African countries has provided valuable insights into the vaccine’s effectiveness, and they are expected to play a critical role in reducing malaria-related deaths and hospitalizations across the continent.
The effort to scale up the malaria vaccination program in Uganda is supported by Gavi, the Vaccine Alliance, which has helped finance the vaccine’s introduction in 19 African countries. Gavi’s funding model relies on co-financing, meaning that countries contribute progressively more to the cost of the vaccine as their income levels rise. However, the future success of the global malaria vaccination program is dependent on sustained financial support, with the next strategic funding period starting in 2026. If adequate funding is not secured, countries may face cuts to their vaccination programs, leading to preventable deaths and setbacks in the fight against malaria.
The WHO continues to support the malaria vaccination effort by offering technical assistance, sharing best practices, and providing guidance to ensure successful implementation. The continued progress of malaria vaccination programs will depend on ongoing collaboration between governments, international organizations, and partners to maintain funding and resources.
Ultimately, the introduction of the R21 vaccine represents a pivotal moment in the battle against malaria, offering new hope for millions of children in Uganda and other affected countries. With continued investment and commitment, these vaccines have the potential to save countless lives and significantly reduce the global malaria burden.
