Beyond RTSS malaria vaccine piloting to adoption and historic introduction in sub-Saharan Africa: a new hope in the fight against the vector-borne disease

Malaria infection remains one of the leading causes of death in sub-Saharan Africa (SSA)(1). The disease has enormous health and economic implications among affected individuals, communities and endemic countries at large (2, 3). The vector-borne infectious disease is caused by Plasmodium species and is spread to humans through the bites of infected hosts, by the female Anopheles mosquitoes (1). Even though five species of Plasmodium exist, P. falciparum is the protozoan parasite associated with severe disease and accounts for most malaria deaths in SSA (4). The World Health Organization (WHO) 2023 World Malaria Report highlighted that, in 2022, there were estimated 249 million cases and 619,000 deaths of malaria globally (5). Between 2019 and 2020, estimated malaria cases increased from 218 million to 230 million and deaths from 552 000 to 604 000. The WHO African Region carries a disproportionately high malaria burden. Around 70% of the global malaria burden is concentrated in 11 SSA countries (5). About 94% of the reported malaria cases in 2022 were in the WHO Africa Region with Nigeria, the Democratic Republic of Congo, Uganda and Mozambique contributing nearly 50% of all the cases (5, 6). The region accounts for 96% of malaria deaths with under-five children accounting for 80% of all deaths in the region (7). Between 2000 and 2015, the SSA oversaw a 40% reduction in clinical disease and 50% reduction in malaria cases due to mass deployment of control interventions such as indoor