Gavi, the Vaccine Alliance, and the United Nations Children’s Fund (UNICEF) have agreed to cut the price of the RTS, S/AS01 malaria vaccine by about 40 per cent, saving an estimated $50 million between 2027 and 2029 and potentially extending immunisation to more African children.

The agreement will reduce the price to €5.50 per dose from early 2027, subject to regulatory and manufacturing milestones, including World Health Organisation (WHO) prequalification of a new production facility.

The savings could fund the complete four-dose vaccination course for up to one million additional children or expand access to other childhood vaccines in countries facing constrained health budgets.

UNICEF negotiated the deal, backed financially by Gavi, with an advance payment facilitated by the International Finance Facility for Immunisation (IFFIm).

UNICEF’s Director of Supply Division, Leila Pakkala, described the agreement as an important step towards expanding access to life-saving malaria vaccines. She said it would also support continued innovation and the development of next-generation vaccines to reduce the disease burden.

Gavi’s Chief Vaccine Programmes and Markets Officer, An Vermeersch, said the agreement demonstrated how financing, technical expertise and strategic partnerships could improve vaccine affordability and access.

The price reduction comes as demand for malaria vaccines exceeds initial projections following the start of their rollout in 2024, while declining international aid funding puts additional pressure on health budgets.

UNICEF has procured and delivered more than 74 million malaria vaccine doses, while Gavi-funded vaccination programmes have been integrated into routine immunisation in 25 African countries, accounting for more than 70 per cent of the global malaria burden.
Gavi aims to vaccinate an additional 50 million children against malaria by 2030.

Malaria remains a major public health threat, particularly in Africa, which accounts for up to 95 per cent of global cases and deaths. Global estimates for 2024 put infections at 282 million and deaths at 610,000, with children under five accounting for about 74 per cent of fatalities.

The burden underscores the need to expand access to prevention, diagnosis and treatment, alongside vaccination. A complete four-dose course of RTS, S/AS01 has been shown to reduce malaria cases by about 75 per cent when administered seasonally in areas with highly seasonal transmission, according to information provided by the organisations.

However, vaccination remains one component of malaria control, alongside insecticide-treated mosquito nets, vector control, preventive medicines, prompt diagnosis and effective treatment.

Climate change further complicates prevention, as rising temperatures may alter transmission patterns and expose previously less affected areas. Flooding and other extreme weather events can also displace communities, damage health infrastructure and disrupt medical services.

The new pricing arrangement builds on the transfer of RTS,S vaccine production from pharmaceutical company GSK to Bharat Biotech of India, intended to expand manufacturing capacity and establish a more sustainable supply.

However, the lower price will not take effect automatically. UNICEF will begin procuring doses under the agreement after the required regulatory and manufacturing conditions have been met, including WHO prequalification of the new facility.

IFFIm Board Chair, Georgina Baker, said the transaction demonstrated how innovative financing could accelerate access to vaccines, increase availability and reduce costs, enabling more children to be protected.

The WHO has prequalified two malaria vaccines: RTS,S/AS01 and R21/Matrix-M. RTS,S was developed by GSK, PATH and their partners, with production being transferred to Bharat Biotech. R21/Matrix-M was co-developed by the University of Oxford and the Serum Institute of India, using adjuvant technology developed by Novavax.

Both vaccines are recommended by the WHO for preventing malaria in children and have been found to be safe and effective. Phase three clinical trials showed that both vaccines reduced malaria cases by more than half during the first year after vaccination, while a fourth dose in the second year of life extended protection.

The impact of the new agreement will depend on whether the anticipated savings translate into wider vaccine coverage, reliable supplies and sustained protection for children in malaria-endemic countries.