Kenya’s role as a pioneer in the Malaria Vaccine Implementation Programme has already saved lives, with a 13% reduction in child mortality observed in pilot regions. We are now entering a new phase with the rollout of the R21/Matrix-M vaccine, which is more cost-effective at approximately $3 per dose and boasts nearly 75% efficacy . Beyond vaccines, the 2025 approval of “Coartem Baby” marks the first treatment specifically formulated for infants weighing as little as 2kg .

However, the effectiveness of these high-tech “shields” is threatened by systemic disconnects. A fourth dose is required in the second year of life to maintain protection, yet many families face logistical and financial barriers to returning to the clinic . There is a persistent risk that advanced tools are being deployed in facilities plagued by drug stockouts and aging bed nets that have exceeded their three-year lifespan .

The 2024 El Niño rains served as a reminder of how quickly these systemic gaps can be exposed, causing spikes in transmission among children in poverty-stricken areas with poor drainage . While vaccines offer a high public health impact, their success is tied to the strength of the underlying health system. Without consistent investment in routine care and the replacement of old infrastructure, the protection offered by these new tools risks waning just as the parasite’s resistance rises .

References:

World Health Organisation Malaria vaccines (RTS,S and R21)

Access to Medicine Foundation Prioritising children in the fight against antimalarial resistance