A future malaria vaccine, if licensed, is likely to be far from perfect — it could cost dollars not cents, and might be far less than 100 per cent effective. This article, explores a hypothetical scenario of a new malaria vaccine being only 30–50 per cent effective. It illustrates the hard decisions policymakers will need to make when trying to allocate funds for malaria prevention and control to only the most cost-effective measures. To inform decision-making, research is needed on how different vaccines would affect malaria epidemics and at what cost, as well as to determine a vaccine delivery mechanism. The article is likely to appeal to non-specialist readers more than some other papers in this special supplement.


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