2022 was a breakthrough year in fighting malaria

Malaria is an ongoing humanitarian disaster. Every year, about half a million people die of the disease, and about 80% of victims are children. We have some effective drugs, and ways of preventing infection such as bed nets, and those methods led to a roughly 50% drop in malaria deaths between 2000 and 2015. But since then, progress has plateaued.

It’s easy to get overexcited by early-stage health science developments — a cancer drug that won’t reach the market for 15 years or a dementia treatment that shows promising results, in mice. But progress on malaria in 2022 looks real. The obstacles now feel less technical and scientific, and more to do with political will.

GSK’s R21 vaccine is only the second successful malaria vaccine ever developed. The first, RTS,S, which was approved by the World Health Organization last year, was only about 50% effective.

But studies suggested that even that less effective vaccine — if 30 million doses of it could be administered in sub-Saharan Africa annually — would save the lives of about 22,000 children under five every year.

Rollout has been slow so far, but Nature reports that the Serum Institute of India has committed to producing 200 million doses of R21 annually, should it be approved.

In November, a monoclonal antibody therapy also showed promise. Antibodies are the proteins our bodies make to fight off disease. Monoclonal antibody therapies are essentially lab-grown versions of them, targeted to a specific pathogen, given to prevent illness.

Early trials suggested that a new drug was between 75% and 90% effective at stopping infection, depending on the dose.

A more technical, but still important, breakthrough was the development of techniques to grow malaria parasite sporozoites in vitro.

Sporozoites are the stage of the parasite lifecycle that gets injected into humans: They grow in mosquitoes’ salivary glands. Injecting people with dead sporozoites highly effectively inoculates them against malaria, but until now they have needed to be harvested by hand from mosquitoes, which is impractical to do at scale.

Scientists announced in December that they had successfully bred them in the lab. As well as directly allowing the sporozoites to be used as vaccines, it should also speed research into the malaria lifecycle and therefore other therapies.