R21/Matrix-M vaccine: optimising supply, maximising impact

Following decades of extensive research and development, a second malaria vaccine, the R21/Matrix-M vaccine, has been recommended by WHO.1 The recommendation comes at a crucial time when progress has stalled over the past decade due to a host of factors, including parasite resistance and persisting suboptimal access to preventive interventions, diagnostics, and therapeutics, with service disruptions by the COVID-19 pandemic posing additional constraints.2 The addition of the new vaccine to the arsenal of malaria control and elimination tools offers a glimmer of hope and creates an impetus for expediting current efforts. Anticipated supply of the R21/Matrix-M vaccine from the Serum Institute of India and the recent agreement between UNICEF and Serum Life Sciences to secure additional supplies are both positive steps.4 However, expanding the number of manufacturers further can help to prevent the risks associated with having a limited pool of producers, such as inadequate or interrupted global supply, should there be unanticipated disruptions (as was evident with the COVID-19 pandemic). [...]enabling vaccine manufacturing in the African continent could have the added advantage of lowering production costs in the medium to long term and could also boost global supply to reach populations in essential need of protection from the devasting burden of malaria. Reducing costs of vaccine production is particularly crucial, given the dire economic situations in many countries bearing the highest burden of malaria—which could ultimately mean less fiscal space for such countries to mobilise and allocate resources to meet broader vaccine financing and co-financing obligations.