Malaria Outbreak Sparks Vaccine Review

Rwanda Explores Malaria Vaccine Integration into National Immunisation Programme

Rwanda is taking steps to evaluate the potential integration of a malaria vaccine into its national immunisation programme. This initiative comes as health officials assess various factors, including scientific evidence, regulatory requirements, and the readiness of the country’s healthcare system, in response to a recent increase in malaria cases. According to Dr. Aimable Mbituyumuremyi, the Division Manager for Malaria and Neglected Tropical Diseases at the Rwanda Biomedical Centre (RBC), the country recorded 114,804 malaria cases in September, compared to 98,000 in August. Among these, 440 cases were classified as severe.

This surge in cases has prompted increased attention on malaria prevention and control measures. Hassan Sibomana, Director of the Vaccine Programmes Unit at RBC, explained that the process of introducing a new vaccine is still in its early stages, and no final decision has been made regarding which specific vaccine will be used. “There are multiple malaria vaccines currently available, and at this stage, I cannot confirm which one will be selected. It requires discussions and agreement before any decision is reached,” Sibomana stated.

Key Steps in Vaccine Introduction

The introduction of any new vaccine follows a defined technical process, which includes several critical steps. First, the vaccine must undergo World Health Organization (WHO) prequalification to ensure it meets global safety and efficacy standards. Next, regulatory approval is required for its use in Rwanda. Additionally, the National Immunisation Technical Advisory Group (NITAG) must provide a recommendation based on the vaccine’s suitability for the local context.

Sibomana emphasized that the assessment also involves evaluating the malaria burden in the country, the affordability of the vaccine, and the capacity of the healthcare system to implement the new vaccination programme. “Most of the challenges associated with vaccine rollout are related to preparation and system readiness, including logistics, financing, and service delivery. These are addressed during the preparation phase before the final readiness assessment,” he said.

Once introduced, the vaccine would be integrated into the routine immunisation programme, ensuring broad access to the population. This approach aims to maximize the impact of the vaccine in reducing malaria transmission and preventing severe cases.

Global Efforts to Expand Malaria Vaccine Access

The discussions in Rwanda align with broader global efforts to expand access to malaria vaccines across Africa. Gavi, the Vaccine Alliance, and UNICEF have significantly reduced the price of the R21/Matrix-M malaria vaccine, making it more affordable for low-income countries. Supported by the International Finance Facility for Immunisation (IFFIm), this deal is expected to make millions of additional doses available, potentially protecting nearly seven million children across the continent over the next five years.

The R21/Matrix-M vaccine, recommended by the WHO in 2023, represents the latest advancement in malaria prevention. It complements the earlier RTS,S/AS01 vaccine, both of which have shown effectiveness in reducing malaria cases by more than 50% in the first year. A fourth dose extends protection into the second year, offering longer-term benefits.

As of November, 24 African countries had already introduced malaria vaccines into their childhood immunisation programmes. Rwanda is now considering similar steps to address the rising number of malaria cases within its borders.

Local Measures to Combat Malaria Spread

In addition to exploring vaccine options, Rwanda is implementing other strategies to curb the spread of malaria. The RBC is conducting indoor residual spraying in 28 of the most affected sectors, including Gisagara, Bugesera, Nyagatare, Rwamagana, and Kirehe. The campaign is set to expand to 55 additional sectors between January and March 2026.

Dr. Mbituyumuremyi highlighted that certain districts, such as Gisagara, Bugesera, Gasabo, Kicukiro, and Nyagatare, accounted for 66% of the national malaria burden in September. Alongside these efforts, community engagement and mobilisation initiatives are ongoing, supported by local leaders and civil society organisations. These activities aim to strengthen malaria prevention during the high-risk season.