New vaccines are helping Ghana approach a long-sought goal of ending child deaths from malaria, demonstrating the potential of the shots to drive back a disease that kills nearly half a million young children every year in Africa, according to the international vaccine aid group Gavi and the country’s health service.
However, aid cutbacks by US President Donald Trump’s administration and other wealthy governments could mean fewer children benefit on the continent where malaria hits hardest, Gavi told Reuters.
Ghana is among the countries that had made significant progress in reducing malaria mortality by scaling up interventions such as the distribution of bed nets treated with insecticides and improving access to preventive drugs and prompt treatment.
Two new vaccines — one developed by British drugmaker GSK, the other by Oxford University and the Serum Institute of India — are helping close the remaining gap, said Dr Selorm Kutsoati, who heads Ghana’s immunisation programme.
“For me the malaria vaccine is a gamechanger,” she told Reuters.
Gavi is he only organisation purchasing malaria shots for African nations. It anticipated it will be able to spend only about $800m (R12.6bn) on the programme over the next five years, or 28% less than the expected need, after falling $2.9bn (R45.7bn) short of its overall funding goal for the period, according to internal estimates prepared for its board of directors in December and seen by Reuters.
[ Novartis receives approval for first malaria drug for babies and childrenOpens in new window ]
An additional 19,000 lives could be lost as a result due to lower vaccination rates, the documents said. The estimate, which has not previously been reported, is based on modelling of the vaccines’ impact by researchers at Imperial College London and the Swiss Tropical and Public Health Institute.
“It is the gap between the promise and the need for the vaccine and the resources we have to provide that,” Scott Gordon, who heads Gavi’s malaria programme, told Reuters.
US health secretary Robert F Kennedy Jnr announced in June last year that Washington would no longer support Gavi, part of sweeping cuts to foreign aid Trump said do not align with his “America First” agenda. The US was previously one of the group’s top donors, contributing about $1.3bn between 2020 and 2024.
The US “remains committed to working with global partners to combat malaria”, a department of health and human services official told Reuters.
However, the Trump administration will not disburse funds to Gavi unless it starts phasing out vaccines containing the mercury-based preservative thimerosal from its portfolio, the official said. Anti-vaccine groups have linked thimerosal to autism and other neurodevelopmental disorders, despite many studies showing no related safety issues.
[ Nigerian company to make HIV, malaria test kits after US funding cutOpens in new window ]
Gavi confirmed the request and said the group remained in contact with the US government on the subject. Any decision related to its portfolio would be “guided by scientific consensus”, it said.
Other donors have also been scaling back support. Britain, Gavi’s biggest donor, has pledged £1.25bn (R27.2bn) over the next five years, more than 20% less than for 2020-25.
Britain’s international development minister Jenny Chapman said the country remains committed to supporting Gavi’s work because it saves lives.
A MOTHER DECIDES: ‘I HAVE TO GO FOR THE VACCINE’
Some major global organisations initially doubted the potential of the two vaccines being rolled out in 24 African countries with help from Gavi.
Based on clinical trials, the World Health Organisation (WHO) estimated they reduce malaria cases by more than 50% during the first year after three shots are administered, an efficacy rate lower than many commonly used childhood shots. A fourth dose is required before a child turns two to maintain protection.
Supporters of the vaccines point to the success in Ghana, saying even a partially effective shot has translated into many lives saved.
“In real-world settings, we’re seeing significant impact,” Gavi’s Gordon said.
Confirmed deaths among children under the age of five have dropped nearly 86% in Ghana, from 245 in 2018, the year before GSK’s vaccine was introduced in select districts, to 35 in 2024, according to government figures. A decade ago, nearly 1,000 children in the age group died each year, Kutsoati said.
Malaria infections have also declined, from roughly 6.7-million in 2018 to 5.3-million in 2024, about a fifth of which were among children under five, Ghana’s figures show.
The actual numbers are likely to be higher as many malaria cases do not get diagnosed, and deaths that occur at home often go unreported, said Dorothy Achu, the WHO’s team lead for malaria in Africa. There can also be inconsistent reporting by some health facilities.
However, Achu agreed the combination of strategies used in Ghana resulted in a “significant reduction in malaria deaths”, adding the WHO is using the country’s figures to update its estimates.
Esther Kolan, a 31-year-old clothing trader, did not need much persuading to get her one-year-old son Phenehas Gyngyi Jnr vaccinated last summer at the Mother and Child Hospital in the southern town of Kasoa.
Her brother died of malaria just before his 15th birthday. A daughter was hospitalised twice with the disease before she turned three.
“I told myself, no matter the condition, I have to go for the vaccine,” Kolan said, adding her family sleeps under bed nets.
Phenehas has had three doses and has never been hospitalised with malaria.
“This has really helped me a lot,” said Kolan, who plans to get him a booster shot soon. “I was not scared for my child.”
Malaria deaths were declining in their district when vaccines became available in 2023, according to Stanley Yaidoo, the municipal health services director. However, the number of cases put pressure on hospitals, exhausting staff and taking up beds that could be used to treat other dangerous diseases, he told Reuters.
“The vaccine implementation was the master stroke that we needed to support existing interventions,” Yaidoo said.
PROGRESS AGAINST A KILLER DISEASE
Some regions managed to eliminate malaria without a vaccine, but countries in sub-Saharan Africa face particular challenges, disease experts said.
Many are among the world’s poorest, with poorly resourced health systems. The prevailing strain is particularly deadly, and there is growing resistance to preventive and curative drugs. Control efforts have been disrupted by conflicts and natural disasters.
The first countries to use the vaccines — Kenya, Malawi and Ghana v were part of a WHO-led pilot programme that began in 2019 with GSK’s shot. The WHO approved the vaccine for wider use in 2021, but the rollout faced hurdles, including a vast supply shortfall.
Access improved when WHO recommended the Oxford shot in 2023.
In many countries it is too early to assess the vaccines’ impact, but there are anecdotal reports of reductions in cases, hospitalisations and deaths among young children, according to the Gavi documents and interviews with health officials in four countries.
Take-up of the vaccines has varied, the documents show. In the first six months of 2025, coverage rates across 11 countries for three doses ranged from more than 70% in Ghana and Burkina Faso to 45% in Liberia and 35% in conflict-hit South Sudan.
Introducing a new vaccine that requires many doses has presented logistical challenges, especially in rural areas where transportation and storage options are limited.
In Ghana, there was also resistance from some traditional and religious leaders, and politicians skeptical about the benefits, Yaidoo told Reuters.
However, results talk, he said.
“Those who have had the vaccination, they give their testimonies on how their children are protected from severe malaria. Many of them are our ambassadors.”
Cases of severe malaria among vaccinated children were 58% lower than among unvaccinated children in the year after they received the third dose across the countries that participated in the pilot, a study published in The Lancet medical journal in January found.
Health officials in Kenya and Malawi did not respond to Reuters’ questions about their vaccination programmes.
At least four more countries plan to introduce malaria vaccines before 2028, Gavi said.
Until this year, Gavi could subsidise 85% of the assessed need for shots in areas of medium and high malaria transmission, with governments contributing as little as $0.20 per dose.
It has reduced its spending cap to 70% for areas that will be ordering shots for the first time, the documents show. It will also be asking all but the poorest governments to increase their contributions, which vary depending on the strength of their economies.
Details of how the changes will affect individual countries are being worked out, Gavi said.
Price cuts for the vaccines could help mitigate the aid cuts. GSK and its partner, India’s Bharat Biotech, said in June last year they would reduce the price of their shot to under $5 a dose by 2028, roughly half what it costs today. In November, Gavi and the UN children’s agency announced a deal to pay 25% less for Serum’s vaccine, presently priced at about $4 per dose, within about a year.
GSK said the real-world data was encouraging, and it was working with Gavi on how to make the roll-out as effective as possible. It did not elaborate. The other companies did not respond to requests for comment.
At least three countries — Burkina Faso, Ivory Coast and Togo — have committed to covering some malaria vaccine needs themselves, Gordon said.
However, Tanzania is struggling to plug funding gaps and will have to delay the start of its vaccination campaign, said Dr Samwel Lazaro, acting head of its malaria programme.
“The government is focused on ensuring the implementation of the most essential and life-saving services, such as the use of medicated bed nets,” Lazaro said.
Reuters
Would you like to comment on this article?
Sign up (it's quick and free) or sign in now.
Please read our Comment Policy before commenting.