Eradicating Malaria in Africa: Potentials and Challenges of Vaccine Deployment

Stephen Oyejide; Abisoye Bilikisu  Ajose; Omoladun Safurat  Ogunbayo; John Oluwayomi  Openibo; Opeoluwa Olutunde  Shodipe; Florence Tolulope  Onifade

doi:10.47419/bjbabs.v6i04.318

Authors

Stephen O. Oyejide Department of Cell Biology and Genetics, University of Lagos, Akoka, Lagos, Nigeria https://orcid.org/0000-0003-3023-4353
Abisoye B. Ajose Department of Community Health and Primary Care, College of Medicine, University of Lagos, Idi-Araba, Lagos, Nigeria https://orcid.org/0009-0003-4529-7557
Omoladun S. Ogunbayo Molecular Biology and Biotechnology Department, Nigerian Institute of Medical Research, Yaba, Lagos, Nigeria https://orcid.org/0009-0003-6623-5988
John O. Openibo African Centre of Excellence for Genomics of Infectious Diseases, Osun State, Nigeria https://orcid.org/0000-0003-1550-647X
Opeoluwa O. Shodipe Department of Microbiology, Nigerian Institute of Medical Research, Yaba, Lagos, Nigeria https://orcid.org/0009-0008-8838-3785
Florence T. Onifade Department of Microbiology, Obafemi Awolowo University, Ile-Ife, Osun, Nigeria https://orcid.org/0009-0000-7108-1942

DOI:

https://doi.org/10.47419/bjbabs.v6i04.318

Keywords:

Africa, Malaria, RTS,S/AS01E malaria vaccine, R21 malaria vaccine, Vaccines

Abstract

Background: According to the World Health Organisation (WHO), malaria remains a leading
burden of illness in low- and middle-income countries accounting for 94% of cases and 95%
of deaths in 2022. As the 2030 Global Goals approach, preventive and chemotherapeutic interventions are necessary to curb the virulence of malaria, making it crucial to review novel
approaches to combat this disease.
Objective: This paper aims to review the top two vaccines for malaria prevention, evaluate
their efficacy, and examine the potential challenges that may arise in their deployment in lowand middle-income countries.
Methods: A comprehensive review was conducted focusing on the leading malaria prevention
vaccines, their effectiveness profiles, and the barriers to implementation in resource-limited
settings.
Results: While vaccine usage demonstrates significant potential for malaria prevention,
considerable challenges exist in vaccine development and large-scale production in low- and
middle-income countries due to limited funding resources. Additionally, misconceptions about
vaccines present barriers to acceptance and uptake.
Conclusions: Although malaria vaccines offer promising preventive potential, successful
deployment in low- and middle-income countries requires addressing funding limitations for
development and production, as well as implementing public enlightenment prog

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References

Aderinto N, Olatunji G, Kokori E, et al. A perspective on Oxford’s R21/Matrix-MTM malaria vaccine and the future of global eradication efforts. Malaria Journal. 2024;23(1):1–4. https://doi.org/10.1186/s12936-024-04846-w

Ahmed S, Khan S, Imran I, et al. Vaccine Development against COVID-19: Study from Pre-Clinical Phases to Clinical Trials and Global

Use. Vaccines. 2021;9(8):1–22. https://doi.org/10.3390/vaccines9080836.

Al Fayez N, Nassar MS, Alshehri AA, et al. Recent Advancement in mRNA Vaccine Development and Applications. Pharmaceutics. 2023;15(7):1972. https://10.3390/pharmaceutics15071972.

Andrade MV, Noronha K,Diniz BPC, et al. The economic burden of malaria: a systematic review. MalariaJournal. 2022;21(1):1–10. https://doi.org/10.1186/s12936-022-04303-6.

Arita I, Nakane M. Road Map for PolioEradication–Establishing the Link with Millennium Development Goal No. 4 for

Child Survival. Japanese Journal of Infectious Diseases. 2008;61(3):169–174. https://doi.org/10.7883/yoken.jjid.2008.169.

Arora NC, Anbalagan L, Pannu AK. Towards Eradication of Malaria: Is the WHO’s RTS,S/AS01 Vaccination Effective Enough? Risk Management and Healthcare Policy. 2021;14:1033–1039. https://doi.org/10.2147/RMHP.S219294.

Ataba E, Dorkenoo AM, Nguepou CT, et al. Potential Emergence of Plasmodium Resistance to Artemisinin Induced by the Use ofArtemisia annua for Malaria and COVID-19 Prevention in Sub-African Region. Acta Parasitologica. 2021;67(1):55–

https://doi.org/10.1007/s11686-021- 00489-y.

Attah CJ, Daniel ZE, Adgidzi GA, et al. A Review ofMalaria Candidate Vaccines; Rationale, Approaches, Prospects and Challenges.

Biomedical Journal of Scientific& Technical Research. 2022;45:11-10.

Bharati K, Das S. Malaria Vaccine Development:Challenges and Prospects. Journal of Clinical and Diagnostic Research. 2019;13(8):1–3.https://doi.org/10.7860/jcdr/2019/19314.130 91.

Chaudhary N, WeissmanD, Whitehead KA. mRNA vaccines for infectious diseases: principles, delivery and

clinical translation. Nature ReviewsDrug Discovery. 2021; 20(11):817–838.

https://doi.org/10.1038/s41573-021-00283-5.

Chavda VP, Hossain MK, Beladiya J et al. Nucleic Acid Vaccines for COVID-19: A Paradigm Shift in the Vaccine Development Arena. Biologics. 2021;1(3):337–356.https://doi.org/10.3390/biologics1030020.

Chevalier-Cottin EP, Ashbaugh H, Brooke N, et al. Communicating Benefits from Vaccines Beyond Preventing Infectious Diseases. Infectious Diseases and Therapy. 2020;9(3):467–480.https://doi.org/10.1007/s40121-020-00312-7.

Datoo MS, Natama HM, Somé A, et al. Efficacy and immunogenicity of R21/Matrix-M vaccine against clinical malaria after 2 years’ follow-up in children in Burkina Faso: a phase 1/2b randomised controlled trial. The Lancet Infectious Diseases. 2022;22(12):1728–1736.

https://doi.org/10.1016/S1473- 3099(22)00442-X.

De SL, Ntumngia FB, Nicholas J, Adams JH. Progress towards the development of a P. vivax vaccine. Expert Rev Vaccines. 2021;20(2):97-112.https://doi.org/10.1080/14760584.2021.1880 898.

Dutta M, Acharya P. Cryo-electron microscopy in the study of virus entry and infection. Frontiers in Molecular Biosciences. 2024;11:1429180. https://doi.org/10.3389/fmolb.2024.1429180.

Dzi KTJ. Issues related to the approval of the R21/Matrix-M malaria vaccine for use in Nigeria and Ghana. Frontiers in Public Health. 2023;11:1–3. https://doi.org/10.3389/fpubh.2023.1237011

Effiong FB, Makata VC, Elebesunu EE, et al. Prospects of malaria vaccination in Nigeria: Anticipated challenges and lessons from previous vaccination campaigns. Annals of Medicine and Surgery. 2022;81:1-4.https://doi.org/10.1016/j.amsu.2022.104385.

El-Moamly AA, El-Sweify MA. Malaria vaccines: the 60-year journey of hope and final success—lessons learned and future prospects. Tropical Medicine and Health. 2023;51(1): 1–18.https://doi.org/10.1186/s41182-023-00516- w.

Feachem SR. Roll Back Malaria: an historical footnote. Malaria Journal. 2018;17(1):1–3.https://doi.org/10.1186/s12936-018-2582-0.

Garett R, Young SD. Online misinformation and vaccine hesitancy. Translational Behavioral Medicine. 2021;11(12):2194–2199.

https://doi.org/10.1093/tbm/ibab128.

Genton B. R21/Matrix-M™ malaria vaccine: a new tool to achieve WHO's goal to eliminate malaria in 30 countries by 2030? Journal of Travel Medicine. 2023;30(8):taad140.

https://doi.org/10.1093/jtm/taad140.

Ghattas M, Dwivedi G, Lavertu M, Alameh MG. Vaccine Technologies and Platforms for Infectious Diseases: Current Progress, Challenges, and Opportunities. Vaccines (Basel). 2021;9(12):1490. https://doi.org/10.3390/vaccines9121490.

Gorki V, Medhi B. Use of artificial intelligence in vaccine development against pathogens: Challenges and future directions. Indian Journal of Pharmacology. 2024;56(2):77-79. https://doi.org/10.4103/ijp.ijp_259_24.

Habtamu K, Petros B, Yan G. Plasmodium vivax: the potential obstacles it presents to malaria elimination and eradication. Tropical Diseases, Travel Medicine and Vaccines. 2022;8(1):1–17.https://doi.org/10.1186/s40794-022-00185-3.

Hogan AB, Winskill P, Ghani AC. Estimated impact of RTS,S/AS01 malaria vaccine allocation strategies in sub- Saharan Africa: A modelling study. PLOS Medicine. 2020;17(11):1-19.https://doi.org/10.1371/journal.pmed.10033 77.

Khan MI, Ikram A, Hamza HB. Vaccine manufacturing capacity in low- and middle-income countries. Bulletin of the World Health Organization. 2021;99(7):479.https://doi.org/10.2471/BLT.20.273375.

Kumraj G, Pathak S, Shah S, et al. Capacity Building for Vaccine Manufacturing Across Developing Countries: The Way Forward. Human Vaccines & Immunotherapeutics. 2022;18(1):2020529. https://doi.org/10.1080/21645515.2021.2020 529.

Laurens MB. RTS,S/AS01 Vaccine (MosquirixTM): an Overview. Human Vaccines & Immunotherapeutics. 2019;16(3):1–10.

https://doi.org/10.1080/21645515.2019.1669 415.

Lee SK, Sun J, Jang S, Connelly S. Misinformation of COVID-19 vaccines and vaccine hesitancy. Scientific Reports. 2022;12(1):1–11.

https://doi.org/10.1038/s41598-022-17430-6.

Leong KY, Tham SK, Poh CL. Revolutionizing immunization: a comprehensive review of mRNA vaccine technology and applications. Virology Journal. 2025; 22(71):1-19https://doi.org/10.1186/s12985-025-02645-6

Li J, Docile HJ, Fisher D, et al. Current Status of Malaria Control and Elimination in Africa: Epidemiology, Diagnosis, Treatment, Progress and Challenges. Journal of Epidemiology and Global Health. 2024;14(3):561-579.https://doi.org/10.1007/s44197-024-00228-2.

Liljeroos L, Malito E, Ferlenghi I, et al. Structural and Computational Biology in the Design of Immunogenic Vaccine Antigens. Journal of Immunology Research. 2015;2015:156241.https://doi.org/10.1155/2015/156241.

Lockyer B, Islam S, Rahman A, et al. Understanding COVID‐19 Misinformation and Vaccine Hesitancy in context: Findings from a Qualitative Study Involving Citizens in Bradford, UK. Health Expectations. 2021;24(4):1159–1168. https://doi.org/10.1111/hex.13240.

Lubanga AF, Bwanali AN, Moyo C, et al. Beyond RTS,S malaria vaccine piloting to adoption and historic introduction in sub- Saharan Africa: a new hope in the fight against the vector-borne disease. Frontiers in Tropical Diseases. 2024;5:1–6. https://doi.org/10.3389/fitd.2024.1387078

Marques-da-Silva C, Peissig K, Kurup SP. Pre-Erythrocytic Vaccines against Malaria. Vaccines. 2020;8(3):1–15.

https://doi.org/10.3390/vaccines8030400.

Moorthy V, Binka F. R21/Matrix-M: a second malaria vaccine? The Lancet. 2021;397(10287):1782–1783.

https://doi.org/10.1016/s0140- 6736(21)01065-5.

Mukhtar M, Wajeeha AW, Zaidi NUSS, Bibi N. Engineering modified mRNA-based vaccine against dengue virus using computational and reverse vaccinology approaches. International Journal of Molecular Sciences. 2022;23(22):13911.

Okumu FO, Moore SJ. Combining indoor residual spraying and insecticide-treated nets for malaria control in Africa: a review of possible outcomes and an outline of suggestions for the future. Malaria Journal. 2011;10:1-13. https://doi.org/10.1186/1475-2875-10-208

Osoro CB, Ochodo E, Kwambai TK, et al. Policy uptake and implementation of the RTS,S/AS01 malaria vaccine in sub- Saharan African countries: status 2 years following the WHO recommendation. BMJ Global Health. 2024;9(4):e014719. https://doi.org/10.1136/bmjgh-2023-014719.

Plowe CV. Malaria chemoprevention and drug resistance: a review of the literature and policy implications. Malaria Journal. 2022;21(1):1–25.https://doi.org/10.1186/s12936-022-04115-8.

Pollard AJ, Bijker EM. A guide to vaccinology: from basic principles to new developments. Nature Reviews Immunology. 2021;21(21):1–18. https://doi.org/10.1038/s41577-020-00479-7.

Praet N, Asante KP, Bozonnat MC, et al. Assessing the safety, impact and effectiveness of RTS,S/AS01E malaria vaccine following its introduction in three sub-Saharan African countries: methodological approaches and study set- up. Malaria Journal. 2022;21(1): 1–12. https://doi.org/10.1186/s12936-022-04144-3.

Price RN, Commons RJ, Battle KE, et al. Plasmodium vivax in the Era of the Shrinking P. falciparum Map. Trends in Parasitology. 2020;36(6):560–570. https://doi.org/10.1016/j.pt.2020.03.009

Saleh A, Qamar S, Tekin A, et al. Vaccine Development Throughout History. Cureus. 2021;13(7):1–7.

Sato S. Plasmodium—a Brief Introduction to the Parasites Causing Human Malaria and Their Basic Biology. Journal of Physiological Anthropology. 2021;40(1):1– https://doi.org/10.1186/s40101-020-00251-9.

Schmit N, Topazian HM, Natama HM, et al. The public health impact and cost- effectiveness of the R21/Matrix-M malaria vaccine: a mathematical modelling study. The Lancet Infectious Diseases. 2024;24(5)- 465–475. https://doi.org/10.1016/S1473-

(23)00816-2

Sinnis P, Fidock DA. The RTS,S vaccine-a chance to regain the upper hand against malaria? Cell. 2022;185(5):750-754. https://doi.org/10.1016/j.cell.2022.01.028.

Stanisic, D.I., Good, M.F. Malaria Vaccines: Progress to Date. BioDrugs. 2023;37:737–756.

Szabó GT, Mahiny AJ, Vlatkovic I. COVID- 19 mRNA vaccines: Platforms and current developments. Molecular Therapy. 2022;30(5):1850-1868.

Tavares W, Morais J, Martins JF, et al. Malaria in Angola: recent progress, challenges and future opportunities using parasite demography studies. Malaria Journal. 2022;21(1):1–13. https://doi.org/10.1186/s12936-022-04424-y.

Thompson HA, Hogan AB, Walker PGT, et al. Seasonal use case for the RTS,S/AS01 malaria vaccine: a mathematical modelling study. The Lancet Global Health. 2022;10(12):1782–1792. https://doi.org/10.1016/S2214- 109X(22)00416-8.

Williams BA, Jones CH, Welch V, et al. Outlook of pandemic preparedness in a post-COVID-19 world. Npj Vaccines. 2023;8(1): 1–12. https://doi.org/10.1038/s41541-023-00773-0

World Health Organization (2019). First malaria vaccine in Africa: A potential new tool for child health and improved malaria control. [online] www.2-23.int. Available at: https://www.who.int/publications/i/item/W HO-CDS-GMP-2018.05 [Accessed 23 Oct. 2023].

World Health Organization (2021). WHO recommends groundbreaking malaria vaccine for children at risk. [online] www.who.int. Available at: https://www.who.int/news/item/06-10-2021- who-recommends-groundbreaking-malaria- vaccine-for-children-at-risk [Accessed 23Oct. 2023].

World Health Organization (2022). Q&A on RTS,S malaria vaccine. [online] www.who.int. Available at: https://www.who.int/news-room/questions- and-answers/item/q-a-on-rts-s-malaria- vaccine [Accessed 10 Oct. 2023].

World Health Organization (2023). Malaria. [online] World Health Organization. Available at: https://www.who.int/news-room/fact- sheets/detail/malaria [Accessed 10 Jan. 2024].