Malawi's war against malaria has received a powerful new weapon following the World Health Organization's approval of the first-ever child-friendly, transmission-blocking formulations of primaquine.
The development marks a major leap for a country already recognised as a global leader in malaria innovation, having become the world's first nation to pilot the RTS,S malaria vaccine in 2019.
The WHO has prequalified 2.5 mg and 5 mg dispersible primaquine tablets, developed by Medicines for Malaria Venture (MMV) and Fosun Pharma with support from Unitaid. Until now, primaquine--critical for preventing relapses and stopping malaria transmission at community level--had no quality-assured format suitable for children.
For years, Malawi's health workers were forced to crush bitter adult tablets just to medicate infants, often resulting in inaccurate dosing and poor compliance. The new dispersible tablets, which dissolve easily in water and are flavour-masked, finally close that gap.
Follow us on WhatsApp | LinkedIn for the latest headlines
"Children are disproportionately affected by malaria, which takes a toll on their health, education and future," said Dr. Philippe Duneton, Unitaid's executive director. "Without putting children at the center of the response, we can't beat malaria."
A Perfect Match for Malawi's RTS,S Vaccine Rollout
The arrival of child-friendly primaquine is expected to significantly reinforce Malawi's RTS,S vaccine programme--the world's first malaria vaccine initiative.
Launched in April 2019, the vaccine is now part of routine immunisation in 11 districts, with plans underway to scale up nationwide. Early data is promising: the vaccine prevents 4 in 10 malaria infections and 3 in 10 severe cases, with hospitals reporting marked reductions in admissions among vaccinated children.
The vaccine's four-dose schedule (administered between 5 and 22 months of age) is backed by WHO as part of a broader package that includes bed nets, indoor residual spraying, and effective treatment.
While the vaccine protects children from infection and severe disease, primaquine cuts off transmission, killing the gametocytes that allow malaria to spread from a sick child to a mosquito--and then back into the community. This is especially important for Plasmodium falciparum, the dominant strain in Malawi.
"A Game-Changer for Elimination"
Dr. Martin Fitchet, MMV's CEO, described the new formulations as transformational:
"Having quality-assured paediatric primaquine in a dispersible format is a game-changer for elimination. It means national programmes can now treat children more effectively."
Sign up for free AllAfrica Newsletters
Get the latest in African news delivered straight to your inbox
Global Partners Back Rapid Rollout
The innovation comes with strong support from a global coalition: WHO, Malawi's Ministry of Health, PATH, UNICEF and GSK spearhead the vaccine rollout, funded by Gavi, the Global Fund and Unitaid.
With WHO prequalification, the new primaquine tablets can now be procured immediately by major funders like the Global Fund, ensuring fast integration into Malawi's national supply chain.
A Turning Point for Child Survival
Children under five account for more than 74% of global malaria deaths. For Malawi, the pairing of child-friendly primaquine with a proven vaccine signals a new chapter--one where the country's most vulnerable children stand a stronger chance of surviving the disease that has long threatened their future.
Malawi's malaria fight has just gained speed -- and the world is watching.
