The World Health Organization’s World Malaria Report for 2022 reveals that despite significant progress in reducing malaria mortality since 2000, the gains have slowed and plateaued in recent years, particularly in sub-Saharan Africa. While efforts to combat malaria have primarily focused on young children and pregnant women, evidence suggests that malaria mortality among adults is on the rise in some highly endemic areas.
The article explores the question of whether it is worth considering and testing the use of malaria vaccines in adults to reduce adult morbidity and mortality and contribute to reducing malaria transmission. The 2000s marked a promising era in malaria control, with the introduction of artemisinins as an effective treatment, the use of co-formulated anti-malarials, and the implementation of preventive measures such as intermittent preventive therapy in pregnant women and insecticide-treated nets.
The establishment of organizations like The Global Fund to Fight AIDS, Tuberculosis, and Malaria and The US President’s Malaria Initiative brought significant funding for malaria control efforts. However, progress has stagnated, and targets set by WHO’s Global Technical Strategy for Malaria have been missed. The reasons for the lack of continued progress include lower-than-expected effectiveness of interventions, suboptimal implementation, insufficient funding, and the rise and spread of artemisinin resistance.
In light of these challenges, considering the use of malaria vaccines in adults could be a potential solution. Vaccines have the potential to reduce adult morbidity and mortality, contribute to reducing transmission, and provide a new approach to tackling malaria. While implementing malaria vaccines in adults would require substantial funding and programmatic support, it could lead to meaningful decline and ultimately elimination of the disease.
1. World Health Organization’s World Malaria Report 2022
2. Evidence on rising malaria mortality among adults in highly endemic areas