The launch of malaria vaccination in Uganda in April 2025 marked a major step in the ongoing fight against one of the world’s deadliest diseases. More than one year later, the program demonstrates wide acceptance and operational feasibility at scale. The main challenge now is to keep children coming back for all four doses.
Dr. Rita Atugonza, Deputy Program Manager at Uganda’s National Expanded Program on Immunization (UNEPI), points to both the scale of the rollout and the level of coordination as major accomplishments.
“One of the most significant achievements has been the rapid and coordinated national rollout across 105 moderate-to-high-transmission districts and cities with a target of over 1.1 million children,” she said.
Malaria is a leading cause of illness and death among children less than five years of age in Uganda. In 2024, the country recorded roughly 13.2 million malaria cases, making it the third-highest contributor of cases globally, after Nigeria and the Democratic Republic of the Congo.
To reduce the malaria burden, Uganda implements several vector control and chemoprevention strategies stratified by disease burden. On April 2, 2025, the Ministry of Health (MOH) launched the vaccine as an additional malaria intervention across all districts with high and moderate malaria transmission.
PATH Uganda Country Director Dr. Betty Mirembe delivers remarks on behalf of all partners that supported the country’s ministry of health in the introduction of the malaria vaccine on April 1, 2025, in Apac District. Credit: PATH.
Strong first-year achievements
The scale of Uganda’s malaria vaccine introduction has required close collaboration among a range of stakeholders, with special cooperation needed between the MOH’s immunization and malaria programs at the national and sub-national levels.
“The rollout was supported by strong leadership from the Ministry of Health through UNEPI and the National Malaria Elimination Division, with effective coordination across all partners and key stakeholders,” said Dr. Atugonza.
An infant receives the malaria vaccine with the Prime Minister of Uganda, Rt Hon Robinah Nabanja, on April 1, 2025, in Apac District. Credit: PATH.
From April 2025 to February 2026, the MOH administered more than 3.1 million doses. Uptake of the first dose among children 6 months to 11 months of age was especially high—roughly 100 percent. Efforts continue to increase uptake of subsequent doses, including doses 2 and 3, which saw coverage of 67 percent and 64 percent, respectively.
Dr. Atugonza noted that initial rollout data showed strong caregiver trust and demand for the vaccine.
“From a service delivery perspective, the program has achieved strong early uptake, with a high number of children receiving the first dose and encouraging progression to subsequent doses,” she said. “While drop-out remains an area for improvement, as expected with a new multi-dose vaccine, the trends are consistent with global experience and provide a strong foundation for improvement.”
Integration into routine immunization
One of the defining successes of Uganda’s approach has been the integration of malaria vaccination into routine immunization services. PATH, which is providing technical assistance for the rollout, worked with UNEPI to train health workers to deliver the vaccine alongside other existing antigens. This assistance also included community engagement as well as efforts to strengthen cold chain, logistics, microplanning, and data systems.
“Introducing the malaria vaccine helped Uganda stress-test and strengthen routine systems—everything from forecasting and cold chain to health worker training and supervision,” said Dr. Atugonza. “Health workers have benefited from continuous capacity building, improving their ability to manage complex schedules, accurately document children in registers, and conduct defaulter tracing.”
She noted that collaboration among health facilities, village health teams, and community structures has further strengthened follow-up for missed doses.
“Introducing the malaria vaccine helped Uganda stress-test and strengthen routine systems—everything from forecasting and cold chain to health worker training and supervision.”— Dr. Rita Atugonza, Deputy Program Manager, UNEPI
Justine Gimbo, an assistant nursing officer and EPI focal person at Buyaga Health Center II in the central Masaka District, emphasized the need for continuous reminders of the malaria vaccine schedule, which adds new visits to the routine immunization calendar.
“We regularly hold health education sessions on immunization,” Gimbo explained. “We began sensitizing caregivers about the malaria vaccine doses, including how many there are and when they can return to receive the next dose. We provide health education on the doses and schedule, so the information sticks with them. We also follow up on the children through defaulter tracking by village health teams.”
From rollout to retention
The four-dose vaccine rollout also relies on participatory efforts that are rooted in community ownership.
Community engagement played a central role throughout the first year. Uganda mobilized a broad range of stakeholders to build trust and demand. These stakeholders included religious, cultural, and political leaders, civil society organizations, academia, and community and health extension workers.
Dr. Jane Nabakooza of the National Malaria Elimination Division said involving trusted community actors and empowering them with relevant data and support are among the keys to completion of the vaccine schedule.
“We are intensifying community engagements by working closely with existing community structures,” she said. “These structures are being supported with accurate data to enable effective microplanning, allowing them to track and follow up [with] children to ensure completion of all the four doses. By empowering communities to own these targets, we aim to improve continuity and retention.”
Uganda is also engaging key stakeholders like pediatricians to maximize every child-facility interaction. This means working with the Uganda Paediatric Association and other healthcare workers to identify children with missed doses and refer them for vaccination.
Looking ahead
During the second year of implementation, priorities are clear: sustained vaccine supply, increased completion of all four doses, more equitable access, and strengthened data use for real-time decision-making. Investments are needed in community engagement, caregiver reminder systems, health worker mentorship, cold chain and logistics, and integrated delivery platforms such as Child Health Days and community-based services.
Shifting global funding priorities also present a challenge, driving a need to accelerate domestic cofinancing, increase efficiencies, and further integrate malaria vaccination into other child health platforms.
“We have shown that malaria vaccination at a large scale is possible,” Dr. Atugonza noted. “The task now is to protect those gains, strengthen sustainability, and translate strong coverage into lasting reductions in malaria-related illnesses and deaths.”
PATH provides technical assistance to the Uganda Ministry of Health for malaria vaccine implementation, with financial support from GiveWell.
