Geneva, Switzerland – May 8, 2026
A rigorous four‑year evaluation of the RTS,S/AS01E malaria vaccine, published today in The Lancet, has confirmed that the world’s first malaria vaccine prevented roughly one in eight child deaths across the three African nations that pioneered its rollout.
Study Design and Scale
The evaluation tracked 158 administrative clusters — each with a birth cohort of roughly 4,000 children — across Ghana, Kenya, and Malawi. Seventy‑nine areas introduced the vaccine in 2019, while 79 comparison areas received it later. Surveillance was built on a network of more than 26,000 local community reporters who notified researchers of child deaths, followed by home visits for verbal autopsy.
"This is very solid evidence of the potential for malaria vaccines to change the trajectory of child mortality in Africa, and why it is urgent to overcome funding challenges to accelerate rollout." — Dr Kate O’Brien, WHO Director of the Department of Immunization, Vaccines and Biologicals, and co‑author of the evaluation
The primary outcome was all‑cause mortality (excluding injury) among children eligible for the third dose. Over 46 months, 5,576 deaths occurred in implementation areas versus 6,152 in comparison areas, a mortality rate ratio of 0.87 (13.2% reduction). Hospital admissions for severe malaria fell by 22%, with no safety signals detected.
Coverage and Dose Completion
Uptake in 2022 was 82.8% for the first dose, 71.1% for the third dose, and 39.9% for the fourth dose. By the end of the evaluation, nearly 1.3 million children had received the first dose, 1.1 million the second, 1.07 million the third, and 436,527 the fourth.
Implications and Next Steps
The findings have direct implications for the 25 African countries that have now added malaria vaccines to childhood immunisation schedules. Many of these nations have malaria burdens equal to or higher than the pilot sites, suggesting the impact could be as great or greater elsewhere.
Funding gaps remain a barrier. While supply meets demand, financing constraints limit scale‑up and sustained coverage. WHO calls for accelerated financing to enable broader rollout.
Sources
- Mwapasa, V., Asante, K. P., Milligan, P., et al. Impact of introducing RTS,S/AS01E malaria vaccine on mortality in young children in Ghana, Kenya, and Malawi: an observational evaluation of a cluster‑randomised implementation programme. The Lancet 2026; 407:1796‑1808. DOI:10.1016/S0140‑6736(26)00248‑5
- World Health Organization. New evidence confirms malaria vaccine saves child lives and will have high impact in wider rollout. 8 May 2026.
- CIDRAP. RTS,S malaria vaccine averted 1 in 8 deaths among eligible kids in 3 African nations over 4 years. 2026.
FIRAT Editorial Board
Institutional Research Desk · Foresight Institute of Research and Translation
The collective editorial and research translation board of FIRAT, synthesising peer-reviewed evidence, policy briefs, and division milestones across our seven foundational research pillars.
