Malaria is on a march

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Scientists at GSK are developing a new malaria vaccine that could be three times more effective than existing jabs for the disease.

So what? Not a moment too soon. Humanity was once on the way to beating malaria. But progress has gone into reverse, with millions of lives at risk. Other infectious diseases on the rise include

• measles – cases in Europe jumped to about 127,000 in 2024, double what was reported in the previous year;
• cholera – cases around the world rose by 13 per cent from 2022 to 2023, with deaths soaring by 71 per cent to more than 100,000; and
• tuberculosis – cases increased by 4.6 per cent from 2020 to 2023 and by 15 per cent in the US from 2022 to 2023.

Swatting. Starting in the 1990s, a huge drive to stamp out malaria brought its prevalence down significantly. More than two billion cases of the mosquito-borne disease were prevented and nearly 13 million lives were saved, most of them children.

Squatting. But malaria cases have risen for five years in a row, increasing by 11 million between 2022 and 2023. Today malaria kills one person every minute and remains endemic in 83 countries.

Here to stay. Some places have seen dramatic rises. In Ethiopia, case numbers increased from 900,000 in 2019 to more than 10 million last year. Last month the World Health Organisation warned that decades of “hard-won gains” in the fight against malaria risk being wiped out.

It's not just malaria. Other infectious diseases are making a comeback after years of successful prevention efforts. This is sometimes down to cost. Spraying homes with insecticides to kill malaria-carrying mosquitoes, for example, is expensive.

But other solutions, such as bed nets, are cheaper. A packet of rehydration salts, which costs just 40p, can save the life of a child suffering from diarrhoea caused by cholera.

So what’s going on? Several factors are behind the surge of infectious diseases, which happened even as Covid was brought to heel. Take malaria:

• Climate change has brought extreme weather and longer rainy seasons to large parts of Africa, which hosts 95 per cent of malaria cases. This creates vast pools of stagnant water ideal for breeding mosquitoes.
• People fleeing conflict in places such as Nigeria, the Democratic Republic of the Congo and Sudan don’t take mosquito nets with them, leaving them unprotected. These wars also batter health systems.
• Mosquitos have developed resistance to insecticides, requiring costlier interventions such as double-spraying bed nets.

There is little funding to expand such prevention programmes. “It’s a perfect storm… a massive disaster,” says Joy Phumaphi, who heads the African Leaders Malaria Alliance.

The good news. In some parts of the world, especially Latin America, malaria is on the retreat thanks to public health interventions. Belize, Cabo Verde and Egypt have succeeded in eradicating malaria altogether, with India also seeing a 69 per cent decline since 2017. Nearly two dozen African countries have rolled out new malaria vaccines in the past year.

The bad news. In September, experts warned there would be 112 million extra malaria cases and 280,700 deaths over three years if funding to fight the disease wasn’t urgently scaled up. Instead aid money is being cut. The US once provided 96 per cent of the bilateral aid to combat malaria. Since March, Donald Trump has terminated 80 per cent of that funding.

The other bad news. The existing vaccines aren’t perfect. One of them has an efficacy rate of 36 per cent in children and reduces deaths by just 13 per cent. The other brings better results, with an efficacy rate of between 68 and 75 per cent. But that still compares unfavourably with the polio vaccine (99-100 per cent efficacy) and Moderna’s Covid jab (95 per cent).

A shot in the arm. GSK’s new vaccine appears promising, potentially offering 90 per cent protection. It kills parasites that get into people’s bloodstreams, while current jabs only target them in the liver. But the vaccine is unproven. Its efficacy may be far lower after thorough testing.

What’s more… It could take 10 years to get it from the lab and into children’s arms.