Professor Sir Adrian Hill
Professor of Vaccinology and Director of the Jenner Institute at Oxford University
After decades of development, last year marked a historic moment for us, when the World Health Organisation approved R21 – the first malaria vaccine to meet the WHO’s stringent 75% efficacy threshold. While this data is incredibly promising, we are facing a formidable challenge when it comes to scaling-up production to meet demand, as well as ensuring fair and widespread distribution.
While there is a wide range of vaccines currently administered to children in Africa to shield against a myriad of deadly diseases, malaria presents a uniquely complex case. Unlike many existing routine immunisations, maximising effectiveness requires multiple doses and customised regimens involving a four-dose schedule. Storing vaccines at the right temperature can also be a substantial logistical challenge, making the thermostability of R21 a real benefit.
Overcoming these barriers requires innovative solutions and a concerted effort from governments, NGOs, and the private sector – which is why our long-standing partnership with the Serum Institute of India has been so integral to the development of R21, as we knew that any very effective vaccine with major impact also had to be ‘fit for purpose’ when it came to meeting manufacturing and distribution requirements. Looking ahead though, we know our mission is far from over. It’s evident that next-generation vaccines are imperative – which is why our partnership is set to continue.
Currently, our development programme and efforts at Oxford University are continuing at pace, with new candidates which target all three stages of the parasite’s life cycle undergoing trials in Africa. Development of such a combination vaccine will further enhance effectiveness and integrate a transmission-blocking vaccine which will be pivotal for the ultimate goal of malaria eradication.
However, it is also important we acknowledge that while vaccines are a critical tool in the fight against malaria, they are not a panacea. Insecticide-treated bed nets, vector control programs, and surveillance efforts must be sustained and augmented to complement vaccination efforts – especially as climate patterns threaten to worsen malaria and other vector-borne diseases like dengue and chikungunya.