Abstract
BACKGROUND: Malaria remains a major public health and economic burden globally, with sub-Saharan Africa (SSA) accounting for over 90% of cases and deaths. Children under five and pregnant women are the most vulnerable. Resistance to artemisinin-based therapies and insecticides has compounded the challenge. This review evaluates malaria mitigation strategies, emphasizing the potential of vaccination, particularly RTS,S/AS01, as a cornerstone for malaria eradication and achievement of Sustainable Development Goal 3 (SDG 3). METHODS: A narrative review approach was adopted. Peer-reviewed literature from 2014 to 2024 was sourced from credible scientific databases, including PubMed, Google Scholar, and ScienceDirect. Selection prioritized studies on malaria control strategies, vaccine trials, efficacy data, implementation frameworks, and health system challenges specific to SSA. The review critically analyzed vaccine trials, community perceptions, and logistical concerns while incorporating the authors' expert perspective. RESULTS: The RTS,S/AS01 vaccine demonstrated moderate efficacy (30-55%) in preventing malaria in children under five in Ghana, Kenya, and Malawi. Other candidates such as R21/Matrix-M showed up to 77% efficacy in trials. Implementation challenges include limited funding, vaccine hesitancy, poor healthcare infrastructure, and community misconceptions. However, integration with routine immunization, enhanced community engagement, and increased investment in health systems significantly improve vaccine acceptance and impact. CONCLUSION: Vaccination represents a promising, cost-effective, and scalable strategy for malaria eradication in SSA. Strengthening healthcare infrastructure, amplifying vaccine acceptance campaigns, and increasing funding for research and vaccine production are pivotal. Malaria vaccination offers a practical and sustainable pathway toward global malaria elimination and the realization of SDG 3 by 2030.