The Democratic Republic of the Congo (DRC) introduced malaria vaccines in October 2024, beginning a new chapter in the journey to protect children from the disease. Malaria imposes a heavy burden in the DRC, where there are an estimated 28 million cases annually, 43 percent of which occur in children younger than five years old.
Malaria vaccines reduce the number of times children get malaria, including severe malaria. The World Health Organization recommends the programmatic use of one of two approved vaccines— RTS,S/AS01 and R21/Matrix-M—for the prevention of Plasmodium falciparum malaria in children living in endemic areas.
PATH is providing technical assistance in the DRC to optimize uptake of the full four-dose malaria vaccine schedule. To boost awareness of the malaria vaccine among caregivers and community members, and to help ensure that children receive the protection achieved by having all four doses of the vaccine, PATH collaborated with the DRC Ministry of Health (MOH) on a new approach that has engaged local groups and organizations to become advocates for malaria vaccination.
Co-creating strategies for awareness
Reaching more children with malaria vaccines starts with building acceptance and awareness in communities. A knowledge, attitudes, and practices survey PATH conducted in partnership with the MOH in 2024 found that only 50 percent of caregivers understood the correct dose schedule for malaria vaccines, while 31 percent feared disapproval from their community or family.
To address these barriers, PATH collaborates with the MOH to identify local groups that could help boost awareness of malaria. This initiative builds on experience from the introduction of COVID-19 vaccines and continued support for the routine immunization system. These non-traditional partners (NTPs) range from school and faith groups to local radio stations and theater troupes.
Florence, a journalist at Radio Okapi, speaks with the chief medical officer in Kindu, DRC. As part of PATH’s non-traditional partners network, she is integrating information about malaria vaccines into her radio programs. Photo: PATH/Yves Ndjadi.
In collaboration with the country’s Provincial Health Division, PATH facilitates co-creation workshops that bring together representatives from non-traditional partners, the Provincial Health Division, and the Expanded Program on Immunization (EPI) to jointly identify barriers and design locally relevant solutions to improve malaria vaccine uptake. Following the workshops, NTPs sign commitments to carry out activities that include informational radio broadcasts, door-to-door campaigns, community dialogues, and religious gatherings.
In Kisangani, the NTP approach has also engaged taxi drivers—an influential and highly connected group within the community. Romain, coordinator of the city’s taxi drivers, participated in a co-creation workshop and quickly saw the potential of his network to support malaria vaccination efforts.
Romain, taxi driver coordinator in Kisangani, Tshopo Province, DRC. Photo: PATH/Yves Ndjadi.
Even in the pouring rain, he moves on his motorcycle between riders with communication materials about malaria vaccines tucked safely under a plastic cover, determined to keep the message circulating. For him, taxi drivers are more than transport providers; they are a daily link between neighborhoods, markets, health facilities, and families.
“We transport lives, so we might as well transport messages that save lives,” he says.
Malaria vaccination is now part of his daily conversations with fellow drivers and passengers—turning each motorcycle into a mobile point of contact between the health system and the community.
Scaling up the approach
Following the initial launch of the NTP approach in Kongo Central, PATH has expanded the strategy to 20 health zones across five provinces: Kongo Central, Kwilu, Equateur, Tshopo, and Maniema. In total, more than 280 partner entities have participated in NTP co-creation workshops across the country, and more than 100 are currently implementing activities to promote malaria vaccine uptake.
In Kongo Central, the strategy is among the interventions that have contributed to promising results: in the first two months after implementation, the dropout rate for the first three malaria vaccine doses fell from 14 percent to 7 percent.
In these initial implementation areas, coverage of the second and third doses exceeded national targets in the first quarter of 2025. Results vary across provinces, but early trends suggest that locally led engagement, combined with effective health worker communication with caregivers and other strategies, can help reduce dropouts between doses.
“If a mother listens to me and decides to vaccinate her child, then my voice will have saved a life.”— Florence, a journalist at Radio Okapi based in Maniema Province, DRC.
In Kwilu Province, the NTP approach has mobilized a growing network of local organizations that serve as trusted advocates for malaria vaccination. Initially designed to engage 40 partners, the initiative now includes 59 community partners, reflecting strong local interest and ownership.
Among them is Evodie, a member of L’Image de la Femme RDC, a women’s rights organization based in Bandundu. After participating in a co-creation workshop organized by the Provincial Health Division and PATH in August 2025, she chose to join the initiative. Since then, she has integrated malaria vaccine awareness into religious gatherings, home visits, educational talks, and activities led by her NGO.
Evodie, a member of L’Image de la Femme RDC, a women’s rights organization based in Bandundu, Kwilu Province, raises awareness about malaria vaccines at an event on the International Day of the Girl Child in October 2025. Photo: Joël Bununi.
In her daily work, Evodie encounters several challenges that continue to affect demand for the malaria vaccine, including parental resistance, confusion about the vaccination schedule, and broader community mistrust. Some parents are unsure about the number of doses required, while others hesitate because of rumors or incomplete information. Her role as a volunteer is to address these concerns directly—creating space for dialogue, answering questions, and emphasizing the importance of completing all four doses of the malaria vaccine schedule.
“Before the workshop, I didn’t know that a malaria vaccine existed. Since then, I have committed myself to helping my community include this tool in its fight against malaria," Evodie recalled. “I speak with parents and community members about why it matters for children’s health. We signed a six-month commitment and are carrying out at least eight activities per month.”
Protecting more children from malaria
Within the Bandundu EPI branch—where PATH provides ongoing support through a dedicated field officer—recent months have seen a steady decline in dropout rates between the first and third dose. While many factors influence vaccination performance, the consistent, community-level engagement led by partners like Evodie has strengthened follow-up with families and helped encourage completion of the vaccine schedule.
Following the co-creation workshops, PATH and the Ministry of Health provide guidance, training, and communication and visibility materials to support NTPs as they implement activities. The teams convene quarterly virtual meetings and conduct follow-up field missions to better understand challenges partners face and identify practical solutions to strengthen demand for malaria vaccination. Organizations also share photos and updates in WhatsApp groups, using these channels to raise questions and exchange lessons learned.
Spreading awareness, saving lives
The NTP program exemplifies how people from many different sectors, professions, and organizations—not just doctors and health workers—are stepping up as malaria prevention advocates. Florence, a journalist at Radio Okapi, a popular radio station based in Maniema Province, is one of them. During one of the workshops, she devised plans to host interviews with experts and interactive sessions about the malaria vaccine on her program.
“I have to turn this data into simple messages for moms and dads,” she said. “If a mother listens to me and decides to vaccinate her child, then my voice will have saved a life.”
