First-ever trial of long-acting injection against malaria to launch in Africa

**Lead**

For the first time, a long‑acting injectable formulation designed to prevent malaria will be tested in humans in Africa, marking a significant milestone in the global effort to eradicate the mosquito‑borne disease. The trial, expected to recruit thousands of participants across several countries, aims to evaluate the safety, tolerability and efficacy of a single‑dose injection that could provide months of protection against Plasmodium falciparum, the deadliest malaria parasite. Researchers hope that, if successful, the injection could revolutionise malaria prevention, especially for vulnerable populations such as children and pregnant women who face the highest risk of severe illness and death.

**Context**

Malaria remains a major public health challenge in sub‑Saharan Africa, where more than 90 per cent of the world’s malaria cases and deaths occur. According to the World Health Organization, the region recorded over 600,000 malaria‑related deaths in 2023, the majority among children under five. Existing preventive measures – including insecticide‑treated bed nets, indoor residual spraying, and seasonal chemoprevention with oral drugs – have helped reduce the burden, but their impact is limited by logistical challenges, drug resistance, and inconsistent use. The recent rollout of the RTS,S/AS01 and R21/Matrix‑M vaccines has offered some hope, but these require multiple doses and do not provide complete protection.

The new injectable candidate, developed by a consortium of academic and pharmaceutical partners, uses a monoclonal antibody or a long‑acting drug formulation that remains active in the body for several months. Early‑phase studies in controlled settings have shown encouraging results, with the injection providing near‑complete protection against experimental malaria infection in volunteers. The upcoming African trial will be the first to test the product under real‑world conditions in malaria‑endemic areas, where transmission is intense and seasonal.

The trial design reflects lessons learned from previous vaccine and drug campaigns. Participants will be randomised to receive either the long‑acting injection or a placebo, and followed for at least 12 months to monitor for malaria infections, adverse events, and immune responses. The study will be conducted in partnership with national malaria control programmes, local health ministries, and experienced research centres in countries such as Mali, Burkina Faso, Kenya, and Tanzania.

**Analise**

This trial represents a paradigm shift in malaria prevention. If the long‑acting injection proves safe and effective, it could overcome many of the barriers that hamper current interventions. Unlike daily or weekly oral prophylaxis, a single injection every few months would simplify adherence, reduce the burden on health systems, and be particularly suited for mobile populations or regions with weak healthcare infrastructure. Moreover, the injectable could be co‑administered with routine childhood immunisations, piggybacking on existing vaccination programmes.

From a scientific standpoint, the success of this approach would validate the use of passive immunisation – providing pre‑formed antibodies – as a viable strategy against a parasitic disease. It could also pave the way for similar long‑acting formulations against other infectious diseases, such as dengue or chikungunya. However, challenges remain. The cost of monoclonal antibodies is currently high, and manufacturing capacity at scale would need to be expanded dramatically. Regulatory pathways in African countries will need to be harmonised, and cold‑chain storage requirements may limit distribution in remote areas.

The political and economic implications are also significant. Malaria costs Africa an estimated $12 billion in lost productivity each year, and donor funding for malaria control has plateaued. A highly effective, long‑acting prophylactic could shift the cost‑benefit calculus, potentially attracting new investment from global health funders and governments. Yet equity must be ensured: the injection must be affordable and accessible to the communities that need it most, not only to travellers or wealthier populations.

**Fontes** This article is based on publicly available information from the World Health Organization, the Malaria Vaccine Initiative at PATH, and press releases from the participating research institutions. No confidential or unreleased data has been used.