UGANDA: MALARIA VACCINE STILL A BIG QUESTION AS AFRICAN COUNTRIES BECOME TESTING GROUNDS FOR THE VACCINE—HEALTH EXPERTS

Gulu School of Health Sciences Don Spells Doom Over Malaria Immunization as Minister of Health Dr. Jane Ruth Aceng Launches Malaria Vaccination in Celebration to Kick the Vices by 2030

GULU CITY – APRIL 25, 2025

By Okumu Livingstone Langol

In Nigeria, the malaria vaccination program witnessed a significant turnout, with mothers and their children embracing immunization. However, on Saturday, April 25, 2025, in Gulu City, the launch of the malaria vaccination saw a contrasting scenario, as mothers failed to turn up to vaccinate their children. Instead, Uganda’s Health Minister, Dr. Jane Ruth Aceng, was welcomed to an empty Kaunda Ground.

Dr. Kasonde G. Mulenga Mwinga, World Health Organization Country Representative, during his opening remarks at the World Malaria Day celebration in Gulu City, stated that this year’s theme, “Eliminate Malaria Now,” is a call to action.

“It reflects our collective commitment to accelerating the fight against malaria and achieving the goal of a malaria-free Uganda by 2030. While this goal may seem ambitious, it is achievable; however, it requires the concerted efforts of all actors, sustained action, and bold investments”, Dr. Kasonde adds.

This World Malaria Day commemoration marks the climax of a series of events conducted across the country this April to raise public awareness about malaria, the available interventions, and the call for individual responsibility towards a malaria-free Uganda. We have had walks against malaria in cities in high-burden regions, a World Malaria Day Scientific Colloquium, and we also launched the Malaria Vaccine,” the WHO head reiterated.

Thomas Tawebwa, the Deputy Speaker of Parliament, in his keynote address read by Dr. Jane Ruth Aceng, stated:

“I welcome you all to this World Malaria Day Commemoration in Gulu City and thank you for your relentless efforts in the fight against malaria.

This day serves as an important milestone in our shared commitment to eliminate malaria, a disease that continues to impact millions of lives around the world and right here in Uganda. Today, we are reminded of the millions of people around the world who continue to suffer and die from malaria, the tremendous progress we have made over the years, and the work that lies ahead to realize our dream of a malaria-free world.

I thank the leadership of Gulu District for hosting us and working tirelessly over the past weeks to ensure that this event is a great success. I urge you to maintain this momentum to ensure that the communities are mobilized to uptake malaria interventions beyond this event.”

Malaria Vaccine Rollout

The launch of the malaria vaccine on April 2, 2025, in Apac District ushered in an era of renewed hope for a malaria-free Uganda. Uganda has initiated the largest malaria vaccination campaign globally, rolling out the vaccine to 105 moderate and high malaria burden districts, targeting to reach 1.1 million children in the first year.

The malaria vaccine, R21/Matrix-M, is now part of the routine childhood immunization schedule. Children under five years of age are eligible to receive this vaccine, which will protect them from severe malaria and death. The vaccine is administered at 6, 7, 8, and 18 months of age. It is WHO-prequalified and registered by the National Drug Authority for use in Uganda. The malaria vaccine is safe, effective, and given free of charge. Caregivers are urged to ensure that their children are taken to the nearby health facility for vaccination to keep them healthy.

This week, Uganda joins the rest of the continent in celebrating Africa Vaccination Week under the theme “Immunization for all is humanly possible.” Vaccination is one of the most powerful and cost-effective tools in public health. As the malaria vaccine is rolled out, emphasis is also placed on routine immunization as a cornerstone of child survival. Routine vaccination protects children from preventable diseases like measles, polio, and tuberculosis. Through campaigns like Integrated Child Health Days (ICHDs) that happen every April and October and community outreaches, vaccine coverage continues to increase, reducing missed opportunities and protecting future generations from vaccine-preventable diseases.

Malaria Situation and Interventions in Uganda

Malaria continues to ravage several countries across the globe, with the hardest hit being in Sub-Saharan Africa. Uganda is ranked the third highest contributor to global malaria cases and the tenth highest contributor to deaths. Malaria accounts for 30-40% of outpatient visits, 20% of hospital admissions, and up to 10% of inpatient deaths. This should not be the case, given that malaria is preventable and curable.

Despite this high burden, the country has made tremendous progress in malaria burden reduction. With the delivery of effective malaria prevention and control interventions, the malaria parasite prevalence in children under five reduced from 42% in 2009 to 9% in 2019, an 80% reduction. These figures are promising and show that the malaria burden can be driven down even further with collective effort.

Key interventions include health promotion and disease prevention (social behavior change, Insecticide-Treated Nets (ITNs), and Indoor Residual Spraying (IRS), Malaria Chemoprevention), curative services (malaria diagnosis, treatment, and malaria in pregnancy) including at the community level, surveillance, monitoring, evaluation, operations research, and epidemic prediction, preparedness, and response. These interventions are intensified according to the epidemiological pattern in each region/district.

Malaria Elimination

Uganda is poised to eliminate malaria by 2030; malaria elimination is both a health and development priority. Every shilling invested in malaria elimination yields gains in health, productivity, and economic growth. The country, a signatory to the Yaoundé Declaration calling for Zero Malaria Deaths, has prioritized the elimination of malaria deaths. To achieve this, special emphasis is placed on correct diagnosis and effective treatment of all uncomplicated malaria cases within 24 hours, timely identification and referral of severe malaria cases, and initiation of both treatment and supportive care within two hours of diagnosis.

All leaders at the city, district, and lower levels are called upon to lead the fight against malaria. Health task forces and committees should be fully constituted and functional, health facilities supported and routinely supervised, and planning, budgeting, and accountability prioritized and seamless.

Adapting to Financial Challenges

There has been a global shake-up following the cessation of funding for several health projects. However, this should not lead to despair. Instead, innovative financing mechanisms must be devised to bridge resource gaps, lobby for increased domestic resource allocation to healthcare, build new partnerships locally and internationally, engage and leverage multisectoral actors in the fight against malaria, and realize efficiencies in implementation through approaches like service integration.

Appreciation is extended to donors, stakeholders, partners, health workers, and communities for their relentless support towards better health in Uganda. Gulu City is thanked for hosting the event and all who have contributed in one way or another towards the success of this World Malaria Day commemoration. Together, efforts must continue to keep malaria elimination at the top of the development agenda, building a healthier Uganda where no one dies from malaria.

Eliminate Malaria Now

Santa Okot, the MP for Aruu North, representing the Malaria Consortium in Uganda Parliament, argued that her team is heading the resource mobilization in the fight against malaria. Uganda Parliament, headed by Deputy Speaker Thomas Tawebwa, formed this initiative to eradicate malaria.

“The 10 Members of Parliament from the Opposition from the Acholi Sub-Region met President Museveni and asked him to support the fight against malaria and the eradication of poverty in the Acholi Sub-Region, which stands at 68%. I believe that malaria is one of the reasons,” Santa Okot reiterated.

She added that after the walk in Gulu City scheduled for May 4, 2025, a drop in malaria cases in the Acholi Sub-Region is anticipated.

Betty Aol Ocan, the Woman MP for Gulu City, accused health workers in the Acholi Sub-Region of not matching up to their professional responsibilities.

“As we celebrate World Health Malaria Day, medical personnel still ask for UGX 24,000 to perform their duty, yet we are losing lives. It looks like the National Medical Store is not in Gulu,” Betty Aol Ocan decried.

The Gulu City Woman MP reasoned that one of the most killer diseases of late in the Acholi Sub-Region is sickle cell. At Gulu Regional Referral Hospital, children line up every Thursday, appealing for treatment.

She added that if malaria were being effectively treated in the Acholi Sub-Region, malaria-related issues would have been reduced. She thanked the authorities for installing a CT scan in Gulu Regional Referral Hospital. However, people still go to Aber Hospital for CT scans.

Betty Aol Ocan expressed concern, saying there should be provisions to support patients who need treatment in Mulago. Another problem is the delay in taking malaria patients to the hospital, which often results in fatalities.

Dr. Jane Ruth Aceng, the Minister of Health and the Chief Guest of Honor, reiterated the importance of not relenting in the fight against malaria.

“In a special way, I want to thank the family of workers in Parliament. This year, 2025, the focus is on Northern Uganda. We launched the vaccine in Apac District on April 2, 2025, an area heavily affected by malaria in Uganda.

I am here representing the Deputy Speaker of Parliament. Allow me to thank the Light Academy students for their poem on eliminating malaria. They speak very sadly because they are the ones attacked by this disease.”

Challenges Facing Malaria Control

In Uganda, there is insufficient support for vaccination efforts, which contributes to continued malaria-related deaths. Despite acknowledging that malaria is detrimental, action is lacking.

“Northern Uganda is the most affected by malaria. We have two types of mosquitoes, while other parts of the country have only one type. When the dry season comes, one type of mosquito cannot survive, but the other persists,” Dr. Jane Ruth Aceng reiterated.

Malaria Vaccine Testing in Africa Raises Concerns

William Ochan Ezra, a lecturer, warns African countries to stop being battlegrounds for biochemical dumping grounds, as the malaria vaccine is being rolled out in Nigeria, South Africa, and Uganda.

In December 2024, Nigeria began rolling out the R21/Matrix-M malaria vaccine, the second malaria vaccine approved by the World Health Organization. The vaccine is being administered to children aged 5 to 15 months as part of Nigeria’s routine immunization schedule.

William Ochan warns African nations that governments should slow down and let trials be conducted in South Africa and Nigeria, where side effects can be monitored before allowing other countries to proceed.

“Africa has often been used as a testing ground for experimental treatments. We must demand transparency about the clinical trials, the possible long-term side effects, and independent oversight before committing to mass vaccination campaigns,” he stated.

Ochan, who teaches pharmacology at the Gulu School of Health Sciences, emphasized that while vaccines are important tools in fighting diseases, they must be backed by rigorous science and ethical considerations.

“The rollout of the R21/Matrix-M vaccine should not just be about public health optics. Communities must be informed and involved in decision-making. Health workers should be trained thoroughly, and robust systems for monitoring adverse reactions should be in place.”

Local civil society groups have also voiced concern about limited community engagement and lack of sensitization prior to the vaccine’s introduction in the Acholi sub-region. Many parents remain skeptical, not only due to misinformation but also because of past experiences with health interventions that lacked transparency.

Nonetheless, health experts urge the public not to dismiss the vaccine altogether but rather to demand better accountability, awareness campaigns, and government commitment to malaria control beyond vaccination — including improvements in healthcare infrastructure, diagnostics, access to treatment, and vector control.

As Uganda embarks on its ambitious goal of eliminating malaria by 2030, it faces a complex path ahead. Vaccines, while promising, are not silver bullets. Success will depend on building public trust, maintaining strong political will, addressing systemic challenges, and ensuring that communities — especially those most affected like those in Northern Uganda — are placed at the center of the fight.