Malaria is devastating to pregnant women and their babies across Africa. A pioneering EU-funded project is currently working to develop a new malaria vaccine to improve protection.
Malaria remains a deadly threat to pregnant women in sub-Saharan Africa, often causing miscarriages, stillbirths, low birth weight babies and severe illness.
A current EU-funded joint research project aims to protect women before they become pregnant. This is an approach that has the potential to transform maternal and newborn health in areas where malaria is endemic.
Dr. Flavia D’Alessio heads vaccine research at the European Vaccine Initiative (EVI) in Heidelberg, Germany, and is coordinating the five-year ADVANCE-VAC4PM project, which runs until 2027. She explained the rationale behind this initiative.
“When a woman becomes pregnant for the first time, she is particularly susceptible to malaria. This parasite infects red blood cells, which invade the placenta and accumulate, causing very harmful consequences for both mother and baby.”
The aim is to develop a vaccine for adolescent girls who have never been pregnant. Similar to the HPV vaccine given to teenagers to prevent cervical cancer, it can provide long-term protection even after a woman begins childbearing.
human impact
The potential impact is huge. According to the World Health Organization (WHO), malaria during pregnancy is associated with the deaths of 75,000 to 200,000 infants and more than 800,000 low birth weight babies each year.
As is known, placental malaria can cause anemia and high blood pressure in the mother, especially during the first pregnancy.
Vaccines under development target a malaria parasite protein called VAR2CSA that allows infected red blood cells to bind to placental tissue. Blocking this protein may not prevent infection, but it can protect pregnant women and their babies from the most dangerous consequences.
Two malaria vaccine candidates are in development. PAMVAC, created by the University of Copenhagen in Denmark, and PRIMVAC, developed by the French National Institute for Health and Medical Research (INSERM) in Paris. Both target similar regions of the same protein.
To increase effectiveness, researchers are exploring new approaches using virus-like particles, non-infectious structures that mimic viruses and help trigger a stronger immune response.
They are also testing whether combining virus-like particle versions of PRIMVAC and PAMVAC could provide broader protection against the disease.
Early progress
Early trials are showing promising results. Both malaria vaccine candidates are safe, well-tolerated, and capable of eliciting strong immune responses.
The next important step is to see if this immune response translates into actual protection. Researchers plan to follow vaccinated women from vaccination through pregnancy and birth of their first child to assess whether they develop less placental malaria than unvaccinated women.
“We need to track women throughout this period to demonstrate their protection,” D’Alessio said.
If successful, the vaccine will undergo rigorous testing before receiving national regulatory approval and WHO prequalification, paving the way for large-scale production and distribution.
international cooperation
The ADVANCE-VAC4PM consortium brings together 10 leading research institutions from Europe and Africa with extensive experience in malaria vaccine development. Key partners include institutions in France, Denmark, the Netherlands, Ghana, Malawi, Burkina Faso and Benin.
Overall coordination is led by EVI, a nonprofit product development partnership working to accelerate safe, effective, and affordable vaccines for diseases that disproportionately impact low- and middle-income countries.
EVI itself is also supported by the EU, along with national governments and other international organizations, through key European partnerships such as the Innovative Health Initiative and the European and Developing Country Clinical Trials Partnership.
The study builds on previous work on these two vaccine candidates, also led by EVI and supported by the Japan-based Global Health Innovation and Technology Fund, and highlights the international nature of the collaboration.
trial in africa
In Burkina Faso, preparations are underway for field trials led by Professor Sodiomon Sirima and his team at Groupe de Recherche Action en Santé, a non-governmental biomedical research institute in Ouagadougou.
Previous studies have vaccinated groups of non-pregnant adult women who have never been pregnant. Early findings confirmed a positive immune response.
“We need to see whether these protections are maintained even after girls become sexually active and subsequently become pregnant,” said Sirima, a leading expert on malaria vaccine research and control strategies.
Depending on the number of pregnancies recorded among participants, this stage can take up to two years.
“The goal is to find a vaccine that is safe and elicits a long-lasting protective immune response,” he stressed.
“This would be a major accomplishment for the vaccine and malaria research communities as a whole if vaccinated women experienced fewer miscarriages, stillbirths, and low birth weight babies.”
Work with existing tools
If approved, this vaccine would complement existing malaria prevention strategies. These include insecticide-treated bed nets and Intermittent Preventive Treatment in Pregnancy (IPTp), a monthly course of medication recommended by the WHO in areas where malaria is endemic.
IPTp has been shown to reduce perinatal mortality by approximately 27% in women in their first or second pregnancy. But the drug is not always available in rural areas, resistance has developed and it cannot be taken during early pregnancy, the exact time when women are most susceptible to infection.
“This is another reason why a malaria vaccine is sorely needed,” D’Alessio stressed.
In addition to clinical research, the ADVANCE-VAC4PM team also invests heavily in capacity development. This includes training graduate students, mentoring young researchers in Africa, strengthening local testing capacity, and developing digital tools to monitor pregnancy outcomes in preparation for large-scale efficacy trials.
Modeling will also be conducted to assess the cost-effectiveness, feasibility, and acceptability of malaria vaccines.
Looking to the future
Although there is a long road to developing a vaccine for placental malaria, momentum is growing.
With two promising candidates in advanced development and coordinated international trials underway, and with clear support from partners in Europe and Africa, the possibility of protecting mothers and children from one of the most devastating complications of malaria is closer than ever.
A successful malaria vaccine could prevent thousands of maternal and child deaths each year. For families across Africa and beyond, it will mean safer pregnancies, healthier babies and new hope in the fight against one of the world’s deadliest diseases.
The research for this article was funded by the EU’s Horizon Programme. The views of the interviewees do not necessarily reflect the views of the European Commission.
This article was originally published in Horizon, EU Research and Innovation Magazine.
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