From innovation to delivery

Despite major advances in prevention and treatment, malaria cases and deaths remain unacceptably high, particularly among young children and pregnant women in Africa. Drug and insecticide resistance, implementation gaps, and underserved high-burden regions continue to drive preventable illness and death.

EDCTP2 malaria projects focus on three main priorities:

• Developing and deploying innovative and ready-to-use tools in real-world health systems
• Accelerating implementation to ensure evidence-based interventions reach communities faster
• Protecting vulnerable populations, including pregnant women, infants, children under five, and recently hospitalised children.

A complete vaccine pipeline: from first use to elimination

EDCTP2 supports a coordinated set of malaria vaccine projects—largely led by African institutions—that together cover the pipeline from first testing to implementation towards elimination:

• MVPE-CC is generating real-world evidence on the RTS,S malaria vaccine and the incremental benefit of a fourth vaccine dose to inform national decision-making and support rollout through routine immunisation.
• MIMVaC-Africa uses controlled human infection models (CHIM) to accelerate the selection of the most promising vaccine candidates, shortening the timeline from candidate identification to deployment.
• MMVC (Multistage Malaria Vaccine Consortium)
develops multi-stage vaccines targeting all stages of the malaria parasite’s cycle. The R21/Matrix-M vaccine has demonstrated high efficacy in a series of trials leading to WHO’s positive recommendation of R21/Matrix-M in 2023 and vaccine rollout across Africa.
• PfTBV advances transmission-blocking vaccines, designed not only to protect individuals but to halt malaria transmission at the community level. Promising transmission-blocking candidates will be combined with vaccines such as R21/Matrix-M.

Together, these efforts demonstrate that high-efficacy vaccines can be achieved and deployed. The next step is to sustain investment, develop next-generation vaccines with improved efficacy, deploy vaccines at scale, and ensure equitable access.

Breakthrough treatments to stay ahead of resistance

On the treatment front, EDCTP2-supported projects are bringing forward the next generation of treatments that respond to growing drug resistance and the need for simpler, more practical regimens:

• The PAMAfrica Consortium develops a portfolio of novel antimalarial drugs and simplified treatment regimens to stay ahead of drug resistance and improve access. The CAPTURE-1 trial (co-funded by Merck KGaA) provided important safety data on cabamiquine–pyronaridine combination. The KARISMA trial is evaluating cipargamin, a fast-acting option for severe malaria. The CALINA trial developed Coartem®(artemether-lumefantrine) Baby, the first and only malaria treatment for newborns and young infants. Coartem® Baby has achieved WHO prequalification, paving the way for access through public procurement to treat malaria in babies weighing less than 5kg. The CALINA and KARISMA studies are co-funded by Novartis and Medicines for Malaria Venture (MMV).
• The WANECAM-2’s KALUMA study provided evidence on a new antimalarial combination of ganaplacide–lumefantrine, achieving cure rates of around 97%, even in areas with resistant parasites. This represents one of the most significant innovations in malaria treatment in decades. The study was co-funded by Novartis.
• SINDOFO develops optimised dosing strategies of a novel, non–artemisinin-based antimalarial combination therapy, ZY19489 – ferroquine (FQ), for the treatment of uncomplicated Plasmodium falciparum. The study is co-funded by Zydus.
• The ASAAP project is testing triple-drug combinations, such as artemether–lumefantrine plus atovaquone–proguanil, to protect existing therapies and reduce the risk of resistance.

Placing equity and vulnerable groups at the centre

EDCTP2’s malaria strategy places equity and the needs of those most at risk at its core by supporting projects on pregnant women, newborns, children under five, and recently hospitalised children in high-burden settings:

• REVIVE-IPTp is improving the uptake and coverage of intermittent preventive treatment in pregnancy (IPTp), particularly in remote, high-prevalence areas. By optimising delivery and coverage, it tackles maternal anaemia, low birth weight, and stillbirth linked to malaria.
• IMPROVE-1 & IMPROVE-2 optimise malaria prevention in pregnancy, adapting strategies to real-world conditions, including in pregnant women living with HIV.
• PYRAPREG generates vital evidence of the safety and effectiveness of new preventive and curative drugs used in pregnancy, especially in the context of evolving resistance.
• MAMAH focuses on reducing malaria infection and disease in pregnant women living with HIV.
• PDMC-II evaluates post-discharge malaria chemoprevention to reduce mortality and recurrent disease among children leaving the hospital.

Strengthening health systems

Ending malaria will require more than individual tools: it depends on strong integrated health systems capable of delivering multiple interventions together—from preventive therapies and vaccines to diagnostics and treatment—and adapting to local contexts. EDCTP2 is supporting projects such as:

• INTEGRATION, which embeds malaria services more deeply within broader health systems, ensuring that diagnosis, treatment and prevention in pregnant women are sustainable and accessible.
• MULTIPLY, which combines effective malaria drugs, routine EPI immunisation campaigns, diagnostics, and preventive measures to maximise impact in children and other high-risk groups.

Building leadership to fight malaria

A key feature of EDCTP’s approach is its commitment to long-term capacity strengthening and African leadership. Clinical trial support is coupled with investments in infrastructure and people, so that EDCTP2-funded projects leave a lasting legacy—such as trial sites able to take part in additional clinical studies and an increased ability of countries to assess and introduce new medical interventions to benefit their populations.

The EDCTP2 fellowship programme has supported a new generation of leaders in malaria research, many now in senior roles across the continent. In total, 43 EDCTP Fellows are conducting malaria research. Below are some examples of these fellows and their work:

• Career Development Fellow Professor Vivi Maketa (Democratic Republic of the Congo) is testing whether highly sensitive rapid diagnostic tests can guide antimalarial treatment in pregnancy in Kinshasa, DRC, comparing standard IPTp with sulfadoxine–pyrimethamine to an ISTp strategy with ultrasensitive tests followed by pyronaridine–artesunate (Pyramax®, PA) in the PYRAPREG study.
• Dr Ally Olotu  (Tanzania) is an EDCTP Senior Fellow and Director of Science at Ifakara Health Institute (IHI). He is leading clinical trials on promising malaria vaccine candidates, employing innovative designs and human infection studies to accelerate development, while building research capacity at IHI.
• Dr Clifford Banda (Malawi) progressed from an EDCTP Industry Fellowship to an EDCTP Career Development Fellowship focused on preventive malaria treatment in pregnant women living with HIV, then to a Wellcome International Training Fellowship and US NIH Emerging Global Leader award. He is now a leading expert in malaria drug dose optimisation for vulnerable populations.
• Professor Pauline Byakika Kibwika (Uganda), an EDCTP Senior Fellow, has led work on malaria–HIV drug interactions, contributed to COVID‑19 treatment studies, and now heads the Department of Medicine at Makerere University School of Medicine. In 2024, she became Vice‑Chancellor of Mbarara University of Science and Technology.