RTS,S malaria vaccine price to fall about 40% to EUR 5.50 a dose; Kenya is moving to R21

UNICEF and Gavi, the Vaccine Alliance, announced on 22 October an agreement that cuts the price of the RTS,S/AS01 malaria vaccine by approximately 40 per cent, to EUR 5.50 a dose. The deal, executed by UNICEF and financially backed by Gavi, is expected to generate around US$50 million in savings between 2027 and 2029.

The lower price is expected to take effect by early 2027. It is subject to regulatory and manufacturing milestones, including prequalification by the World Health Organization (WHO) of a new manufacturing facility with greater supply capacity. UNICEF will not begin procuring doses until those milestones are met.

Kenya has given RTS,S since September 2019. The Star reported on 27 October that the country began moving to R21/Matrix-M, the second malaria vaccine recommended by WHO, in 2025. The paper said the price per dose would fall from KSh 1,354 to about KSh 800, and that what Kenya saves will depend on its procurement arrangements and the vaccine it uses.

The Star also cited WHO as saying countries supported by Gavi, Kenya among them, pay as little as about KSh 26 a dose under co-financing. That is not the price procurement agencies pay manufacturers.

Both RTS,S and R21 act against Plasmodium falciparum, the deadliest malaria parasite worldwide, according to WHO. WHO recommended RTS,S in October 2021 and R21 in October 2023. The schedule is four doses, starting from around five months of age.

In phase 3 clinical trials both vaccines reduced malaria cases by more than 50 per cent in the first year after vaccination, WHO says. Given seasonally in areas of highly seasonal transmission, alongside seasonal malaria chemoprevention (preventive medicine given during the high-risk months), both cut cases by about 75 per cent.

Kenya was one of three pilot countries, with Ghana and Malawi. Between 2019 and 2023 more than 2 million children were reached across the three, and WHO reports a vaccine-attributable 13 per cent drop in mortality among children old enough to be vaccinated. The Star, citing WHO's Kenya annual report, said that by 2023 more than 650,000 Kenyan children had received at least one dose and more than 1.8 million doses had been given. The Kenyan programme initially targeted about 120,000 children a year across eight counties in western Kenya and was extended to 12 more subcounties in 2025.

The price cut builds on the transfer of the vaccine's production from GSK to Bharat Biotech, which UNICEF describes as a developing-country manufacturer. The deal was enabled by an advance payment from the International Finance Facility for Immunisation (IFFIm), which uses government pledges to back vaccine bonds sold to investors. The new facility awaiting prequalification is in India, The Star said.

UNICEF says the savings could protect up to 1 million more children with the full four-dose course. Gavi-funded malaria vaccination is part of routine immunisation in 25 African countries that bear more than 70 per cent of the global malaria burden, and UNICEF has procured and delivered more than 74 million doses. Gavi aims to vaccinate 50 million more children against malaria by 2030.

UNICEF puts the 2024 toll at an estimated 282 million malaria cases and 610,000 deaths worldwide, with up to 95 per cent of both in Africa. Around 74 per cent of the deaths were among children under five.

Leila Pakkala, Director of the UNICEF Supply Division, called the agreement “an important step towards protecting more children from malaria”. An Vermeersch, Gavi’s Chief Vaccine Programmes & Markets Officer, said it shows what the Vaccine Alliance does best, “bringing together financing, technical expertise and strategic partnerships”. Georgina Baker, chair of the IFFIm board, said: “We were created to accelerate vaccine access, increase availability, and help lower costs.”