Hope Is A Verb - A Shot At History, Part 1 - The Stakes

Episode Date: September 5, 2025

As one of our oldest and most relentless enemies, the arrival of two malaria vaccines, has the potential to change the future of humanity. In this first episode, we’ll show you what’s at stake for the millions of families across Sub-Saharan Africa who carry the burden of malaria, the economic and personal cost of this disease and the remarkable tale of the world’s first malaria vaccine that fought all possible odds to make it out of the lab and change the world. Here’s who you’ll meet:Angus Hervey: Founder of Fix The News. Teresa Chirwa-Ndanga: Journalist & human rights activist, Malawi.Dr Mary Hamel: Senior Technical Officer, Team Lead,Malaria Vaccines at WHOZacharia Kafuko: Director of 1Day AfricaDr Rose Jalang'o: Head of the National Vaccines and Immunization Program, KenyaAlanta Colley: Public health worker & science communicator  A Shot At History was produced by Fix The News. Series & Story Producer, Amy Davoren-Rose, Fix The News. Associate Producer & Audio Director, Anthony Badolato, Hear That? Research Producer, Marcus Costello and AudioCraft.Get in touch: [e-mail]

Let me tell you, when my daughter was eight months, I was at work, and around 12, my husband calls me, she's like, the baby has a very high fever, and we didn't have a car at that time. So he's like, what do we do? I'm like, my workplace was closer to a private hospital. Okay, can you start off and we meet up at this clinic? He comes and we meet close to the facility. I hold my daughter and she's burning. And I knew it.

I knew it. I was like, oh, my God, this is malaria. Sorry, I'm becoming emotional. And I knew we were going to be admitted. So we go there and they treated as an imageus case. Oh my God, that moment felt like I was losing my baby. She was vomiting. And it was so fast.

I say it in the morning, she had a slight fever and I was like, you know, babies. By noon, it was around 40 degrees. And the doctors started like saying, you know, if you had delayed by an hour, that's how babies die. The voice you just heard is Teresa Chiron Danga, a mother and journalist from Malawi and my guide for this series. Malaria is one of the deadliest diseases of all time, responsible for more deaths than all of humanity's wars combined. Today, 95% of malaria deaths happen in Africa, and most of them are children under five. For a disease like malaria, which is killing 1,000, African children every day.

This should be a firestorm of concern. So the bigger question is, why does it seem like people are just going about their life normally? For the first time in history, we have not one but two vaccines for malaria being delivered across the length and breadth of sub-Saharan Africa. Four doses before a child's second birthday

can mean the difference between survival and tragedy. My name is Salema-Zenabai. I'm glad to meet with you on the discussion of malaria, the disease that spear no one. None of this has been easy. From the decades of scientific trial and error, It took a very long time from the beginning of the project in 1987, but I do not believe that there was any way we could have gone much faster.

To the years of campaigning within global health organizations. I really saw that this was a disease that affected the finances of the of the families, the growth of communities and cultures. And the last mile challenges of getting the vaccine into communities who need it most. We've had cholera epidemics, we've had healthcare worker strikes, we had an outbreak of polio,

we've had typhoons, we've had flooding. I wonder, really, is this thing going to ever take off? No one knew what was going to happen. At every turn, people have fought the odds. I saw the pain and the anguish that my mother in particular went through. So I promise myself whenever I have an opportunity to contribute to any efforts that will address this problem so that no mother goes through this pain again, I will do it with all efforts.

I'm getting goosebumps remembering this. To fight for a better future. When I think about the end of malaria, I think about how this could actually change how the world thinks about us. I think that within our lifetime, our children's children will see that my father, my mother, my grandmother was part of the process and we can all share the glory it's one of the greatest public health stories of all time millions of children have already received at least one dose of the vaccine and it's working the director of health services in that city was saying that he was having to close down child health wards because they didn't have kids filling the beds for malaria

but the fight is far from over with recent cuts to global aid threatening to stall or even reverse progress. There is so much at stake. This is more than just a shock in the arm. This is a shot at history. I'm Gus Harvey. I'm the editor of Fix the News, an independent media publication

that reports hidden stories of progress. Just over a year ago, we decided that we wanted to tell the story of the malaria vaccine, arguably one of the most important news stories in the world right now, and yet one that you'd struggle to find in any of today's headlines. I remember first hearing about the possibility of a vaccine for malaria back in 2017 when it was still in trials, and thinking to myself, you know, if this works, it is going to be huge. So when we decided to make a podcast about it, we knew this was going to be a big story to wrangle, but it turned out to be far greater and far more complicated than we could

ever have imagined. So many players, so many moving parts, so many twists and turns. Over the next three episodes, we're going to show you why the story matters so much, what it takes to develop and roll out a new vaccine at this scale, and how it could change the narrative, not just of Africa, of an entire continent, but of humanity itself. The thing about being. stories though is that they can't be told by one person. We needed eyes and ears on the ground and that's how we found Teresa. Teresa, do you remember the first time you heard from us? Yeah, it was close to a year ago and I was like, huh? This would be like telling the story that I've never told about.

myself and my country in an international space. So I'm a journalist, worked locally in Malawi since 2017. And the story about malaria, we have told this story on a local radio station and trying to make it an important story. Malawi being one of the poorest countries in the world, they already know the message. they have experienced suffering from malaria. So when I got an email,

it felt like a great opportunity to tell a lived experience. Tell my life story and something that is really huge but has never been told to that extent. When you say to tell your life story, the idea that malaria is so intimately bound up in your life story, it sounds like it's always been the touch point. Yeah. I honestly feel like you know how as a kid you're learning a language when you're growing up

and it's just a part of you, you know. I feel like growing up, there was always the story about malaria. I was born in Zimbabwe and I don't remember malaria being as prominent as it was when we went back to my home country in Malawi. So I would say maybe from nine years old When we started living in my village in Malawi This is a remote area It really became like

Oh my God, like there's this disease out here And we need to really take care Every evening we would sleep under a mosquito net And most communities will also have What I would call indigenous ways to try to prevent malaria. But even with that, my brother and I got really sick from malaria.

It was really terrible. I thought I was going to die, honestly. I thought I was going to die. I mean, you were young, but you still remember how terrible it was? I mean, my body was burning. I remember it was like having a combination of diarrhea, you are vomiting.

your body is on fire and you're chilly you feel super cold at the same time if gas you were to have malaria today you would feel like oh my God I think I'm saying goodbye to this world Teresa's experience plays out

millions of times a year a small fever at breakfast turns into a hospital dash by noon children carried through crowded wards families waiting through the night. Malaria is not an outbreak. It's a daily grinding reality, which is why a vaccine is so important.

And it hasn't come out of nowhere either. It's the latest in a long line of different interventions. Let's quickly wind back the clock and look at how we've tried to deal with this disease in the past. Some of the approaches have been pretty wild. In the 1990s, for example, there was an attempt to drop bed nets out of planes. I spoke with Alanta Colley, an Australian aid worker

who worked in malaria programs in Uganda and Kenya. She remembers studying this campaign as part of her master's degree in public health. The rollout was literally planes flying over parts of remote Western Africa, dropping bundles of insecticide-treated bed nets on communities. The problem is that these were communities that didn't, know these nets were coming. Hadn't been involved. There'd been no community outreach or engagement. And the rates of malaria across Western Africa are actually dramatically increased in this time.

And it's this very telling case study that we talk about in public health. If you're not starting with community, if you're not listening to what community want and need, you can have the most perfect idea in the world. It's not going to land. So our big program in Uganda was rolling out pyrethrum-treated mosquito nets. They were the best in the world at that time. And I would drop in on families and ask if you've been using the net. And people kept asking, can we have a net that's a different colour? The nets were white and they would get covered in smoke particles and ash because the families

would light kerosene lamps. And so there's quite a lot of smoke circulating around. So they'd take those pyrethrum-treated nets, which were absolutely not supposed to be washed. and they would wash them because people were house proud and wanted a clean living space. In doing so, they're making that net far less effective. What are some of the other efforts to try and eradicate the disease? Since the year 2000, rates of malaria mortality have dropped by 60%. So if you're looking at a global level, malaria has dramatically reduced.

It used to be on every continent pretty much across the world, including Australia. We had malaria in the Northern Territory. So we have seen some really effective. initiatives to eradicate it. Lots of spraying a DDT in households is very effective. It's obviously not ideal for other reasons. Draining of swamps, that's a huge one. Stagnant water is where we breed malaria. So if you can eradicate the mosquito breeding ground, you can see a dramatic reduction. The other side of the coin is we've seen a dramatic increase across the world in rapid diagnostic testing and anti-malarials. So there's had a huge.

huge impact, but sub-Saharan Africa is where the global burden is, and it is proving the hardest part of the world is to actually grapple with malaria and really impact those numbers. We've been fighting malaria for a long time, and in most of the world, it's no longer a major public health problem. But in sub-Saharan Africa, the disease has proved far harder to control. Malaria is so common in Africa that the question of the problem. would actually be, do you know anyone who has never heard of a person dying of malaria? When you get malaria, you basically just become a different person, especially when you're young, you realize that it's very easy to die. It's very, very easy to die. That's why ensuring that

people get access to vaccines, we can prevent not just a disease itself, but also the suffering that comes along with malaria infections. This is Zachariah Kofoko, a molecular biochemist in Zambia, and one of the first people we spoke to for this series. He's the director of One Day Africa, an organization that's working to fast track the roll out of the malaria vaccine to make sure that it reaches as many kids as possible. For a disease like malaria, which is killing 1,000 African children every day, every day, 1,000 children, this should be a firestorm of concern everywhere in the world. So the bigger question is, why does it seem like people are just going about their life normally?

You know, why they lead to interest for a disease that is claiming 1,000 children below the age of five? I still can't get out of my head. That statistic that 1,000 African babies die every day from this thing. Oh my God, gas, if I took you to a public hospital in a rural area, you would be shocked. You will see how we have this single bed, but you have two or three kids sharing that bed.

So you have one kid facing this side, another kid facing the other side. So their legs meet up in the middle. And some will have to be sleeping on the floor and others will even be in the verandas because there's no space. And every day, we have a lot of kids dying

simply because parents take their kids late to hospital most parents who arrive at the hospital and they'll be told your baby has already died they've already passed you know so that's why time is of essence for babies you really have to be fast I mean think of me I was able to quickly take my kid to the hospital but think of a mother who is in a village, yeah.

In a village where they don't even have public transport that works, where just to walk to the hospital would take them more than the hour that I'm talking about. Yeah. It's terrible. So we know that malaria is still very much with us. It's been pushed back in much of the world, but in Africa it endures a daily nightmare for parents and still the greatest killer of children on the continent. Entire generations have grown up under its shadow.

Nets, drugs, public health campaigns, they've helped, but babies still slip away, hour after hour. Children, when they get malaria and the parasite attacks of red blood cells, you just can't get oxygen to your vital organs. And children can die within 20, four to 48 hours after the onset of fever. One person who knows this better than almost anyone alive is Dr. Mary Hamill, a senior technical officer at the World Health Organization and team lead for malaria vaccines.

She's been fighting to solve malaria on the ground and in the corridors of global health for over 30 years. Well, I first saw malaria way back when I was 21, my first health visit to Africa, but started really working in malaria in 1995 when I worked for the U.S. Centers for Disease Control. Back at that time, we didn't even have insecticide-treated bed nets recommended globally. This situation was pretty dire. Long lines of parents, usually mothers,

waiting to be seen at clinics. And tragically, sometimes children would die waiting in line to be seen. I really saw that this was a disease that affected every family and it was a tragedy. The pain of losing a child, it affected the finances of the families,

the growth of communities and cultures. Malaria is a disease of poverty. It's cyclical and it keeps people poor. Mary raises an important. point. Malaria doesn't just take lives. It drains household income, keeps children out of school, weakens entire workforces. It's a disease of poverty that deepens poverty, a cycle that holds back families, communities and entire nations. I was watching a movie recently and there was a line in there. Poverty is expensive.

And I was just like, how ironic, but that kind of describes the situation for most families in Malawi. And I don't know how to put it, but you lose a lot in the long run just because you're poor. If malaria was prevalent in a developed country, they were. they would have had it under control because they have the resources. Obviously, the hunger situation, this is also a big problem, by the way, in my country. Instead of focusing on infrastructure development,

we are always trying to find solutions to hunger. We are using those funds to just solve today's problems. It's difficult to see how malaria may affect. food output, but it's a very close and direct link. And in the end, it does affect the entire nation. Our economy is supported from farming. And the majority of farmers are female. It therefore

means that once a mother is up and down with a child sick, it affects their work. And farming is seasonal. So if it's weeding time the moment you don't go and weed at the time that is required, your crop is affected. It then will affect your returns in terms of the yield.

It will affect the household money and just going through this back and forth malaria and my child is sick. You are also stressed most of the times. Sometimes we don't count the cost of stress. Can you tell me more about that. When your daughter got malaria, how did that affect you? When my child

was sick, my husband was home, he was on leave, but I was the one who was supposed to be with the child, and I want to be with my child. But at the same time, it takes away days from my workplace. At the time, I was the only female in my workplace. At the time, I was the only female in management. Now, if it happens so often, it means I'm very often out of the office. Yeah. And in the long run,

my bosses would feel like, maybe it wasn't a great idea having a female manager, you know, in this position. So it's also a cost to female leadership in general. Theresa's point is striking. Malaria costs so much more

than just your health. And for her, it's personal. I keep thinking of Teresa as a nine-year-old girl, getting malaria for the first time. I wanted to know, was she scared that it might come back? I mean, does the sound of a mosquito still make her flinch? There was that feeling, but at the same time, I did understand it was like a baptism.

You know, it was like, okay, I've been initiated into this. My parents were able to find medication for us, and we got better. And that's not to say that I wasn't afraid to have those mosquito bites. We were always cautious, but we also knew that there was really no way to avoid the mosquito bites. You know, you can sleep under a mosquito net, but when you're eating in the evening in the living room, they're biting your legs. We kind of learnt to live with it, however bad that sounds. that reality that in Africa you just have to live with malaria because it's everywhere well that's what drove scientists and health workers to search for something new

previous tools like bed nets or DDT focused on killing the mosquitoes or stopping them from getting to you a vaccine though turns the fight inward it assumes the mosquito will get to you and it prepares the human body for that inevitable bias vaccines have of course changed human history since jana's first smallpox inoculation in 1796 immunization has successfully taken on some of our deadliest diseases polio measles diphtheria but malaria is different

it hides inside human cells changing form as it moves from mosquito to liver to blood crafting a vaccine against that shape-shifting parasite was always going to be one of medicine's hardest puzzles. Here's Alanticole again. It's a very complicated parasite. It goes through quite a few different life stages. The plasmodium parasite starts off in the mosquito in one form. It hides out in a human's liver in a different form.

Then it's released into the red blood cells and takes on a different form. There's periods of sexual and asexual reproduction in that full cycle. And so any vaccine, it's really hard for it to latch on to any specific stage of that full life cycle because it's morphing constantly. A lot of the different stages of malaria are done inside human cells. It happens inside a liver cell and it happens inside a red blood cell. The technical phrase is immunologically silent. The immune system can't see it.

So it's got a little cloak on. from your immune system, that's been really hard for researchers to crack. When Lantus says it's been hard to crack, she means nearly a century of failed experiments and dead ends. Generations of scientists across continents and laboratories, passing the baton in a long relay to find this vaccine. We'll get more into the science later in the series, but for now what you need to know is that the big breakthrough came in 1987. when a team at Glaxo-SmithKline in Belgium produced the first version of a malaria vaccine. Turning that discovery into an actual jab for children, though, would take another three decades of trials and testing.

It was really hailed as this scientific and historic breakthrough, and it took a huge amount of dedication by thousands of scientists, tens of thousands of volunteers. It had such a long journey. In the vaccine world, we talk about two valleys of death. And the first valley of death is when you have to bring it from the trial stage to where you can scale it up. Because that takes somebody to invest the money in this vaccine. The second valley of death is when you bring it to the population.

So there were a lot of periods during the development of the vaccine when this could fail. Mary, when was the first moment that you knew the vaccine was going to work? Yeah, I remember exactly how that felt. I was one of the 11 principal investigators in Kenya who was working on the phase three trial of the malaria vaccine. A phase three trial is the last step. before an intervention can be considered for use. I have to tell you, I'm getting goosebumps remembering this because the moment was so incredible.

We had the results up on a screen and I remember gasping. Children who were vaccinated had a reduction in malaria and severe malaria by 50%. So cut in half. And we were thrilled because where I worked, children averaged six cases of malaria per year. And every time they got malaria,

they were at risk of that progressing to death. So you can imagine what was going to happen to cut this risk by half. Although the trial results were positive, the World Health Organization chose not to move straight into a full rollout. Instead, it approved a pilot program in three of the most malaria endemic countries, Ghana, Kenya, and Malawi. This wasn't just a formality. It was designed as a critical safeguard. Remember, this was the world's first ever vaccine for a parasitic disease, meant to be given to small babies in places where health systems often struggled to provide. even the most basic care.

And the scale of this pilot would be unprecedented. Each year, across the three countries, more than 300,000 children would be vaccinated. Health workers would track everything, whether families came back for all four doses, how safe the vaccine was, and whether the protections seen in clinical trials would hold up in the real messy world

in crowded wards and rural clinics. To put it in perspective, most phase three trials for childhood vaccines, involved just a few thousand children, maybe 10 or 15,000 at the most. The malaria vaccine pilots were designed to reach more than 60 times that number. They weren't going to be ordinary trials. They were going to be full-scale dress rehearsals for a continental rollout. Teresa, do you remember what it was like back in 2019 when Malawi started rolling up this pilot?

Yeah. When Malawi was included as one of the pilot countries, I was already a mother, obviously. And I was like, oh my God, just in time. You know? And at that time, I was director of news at my workplace. And I actually told the reporter who was doing the story, we need a special report because it's a big story.

So this new vaccine is just an additional tool to the control and elimination of malaria in this country. This vaccine has a potential of preventing 1 million cases. And at the moment, we experienced 6 million cases. I was excited, but I'm educated, and I do know the science behind it. Obviously, this is a country that is deep-rooted into superstition, and that's the dilemma of this issue. Malaria would affect the rural mothers more than the urban mother,

because at least I have options. But at the same time, when the vaccine comes, you have the rural mother being skeptical about that vaccine, even though they are the most hit. So our task was really, let's tell this big story. But at the same time, we really need to make sure that the mother in the rural area understands that this is for their own good. So that particular assignment was invested.

in the vernacular language because we really needed it to reach the woman in the rural area. For me, it was just like, you know what? This is a big story. We need to tell it. And I was just so excited for the young mothers, you know, because you see a mother

rushing to the hospital with a baby and instantly feel like it's yourself because you know every emotion that mother is going through. In Kenya, the stakes were just as high. Coordinating the pilot for a new vaccine was a mammoth undertaking, and the responsibility fell on the shoulders of Dr. Rose Jolango, only days into her new job at the Ministry of Health. I honestly had mixed feelings.

I'm new at work. I'm new in the vaccination program. And my boss told me you're going to run with this malaria vaccine pilot program. That's one of the days within my career, there was a paradigm shift. As a medical doctor and having been born in the endemic area where I know the consequences of what malaria can do, going back to my community with a solution, I think that's one of the best feelings that I have ever felt in my life. Rose and her team hit the ground running. In September 2019, Kenya's pilot roll-up began at a local school in Homer Bay County on

the shores of Lake Victoria, one of the regions hardest hit by malaria. It felt like my wedding date because I'd been working towards this 13th, September 2019. And when that day came, it was making history in the world. We had children under five running within the playground. All the local leaders were present. Traditional dancers, traditional music, clubs in the air, laughter in the air. And the communities all dressed in colorful dresses. We had caregivers who had actually volunteered to have their babies, receive the malaria vaccine,

because the malaria disease denies many children an opportunity to celebrate their fifth birthday. So they were just coming to say, I trust you to have my child vaccinated. I remember reading about this Malawian mother. Her name was Gilambeta, and her daughter's name was Lucitana. I remember reading that story. And she was five months old and the first child in Malawi to get the vaccine.

And I think about the symbolism of that moment after this disease that killed so many babies and cut short so many young lives with so much potential, but also how it must have felt to be the first mother in a country to hand over your baby, the courage that takes. So I put myself in little Lusitana's mom's shoes, and I feel her. I feel like I totally understand the moment that she decided, I'm going to do this. I'm going to say yes, and yes, I'm going to present my child for this malaria vaccine. Why this story is so fascinating is the story of trust. she didn't have clear evidence that other mothers would testify that the malaria vaccine has worked for their children.

She was the first. But she trusted the medical personnel what they were telling her, the picture they painted. So it's a story of a hoped gift of protection for her child and that maybe this will help us skip. the nights of fever, we might be able to skip rushed trips to overcrowded clinics. And this is a story that gives confidence to so many other mothers to take that chance, to grab that gift of protection for their children, simply because one mother decided to take the very first step. So, it's early 2020, the pilot is off to have.

a great start across all three countries. The mothers are lining up. The health care systems are on board. This vaccine that's been decades in the making is finally arriving in communities. And then global health gets the mother of all curveballs. Coronavirus. Coronavirus. They're rapidly spreading virus.

Urging its citizens not to travel abroad. COVID-19 can be characterized as a pandemic. It's a pandemic affecting everyone in their world. the orders of lockdown, stay at home, and essential services literally stopped. So at that point, I wondered, is this thing going to ever take off? For how long are we going to be in this? Is it really going to work? Next time on a shot at history.

The world's first malaria vaccine, finds a way through COVID-19. Healthcare workers would actually carry the cooler boxes with the vaccines on a bike and went door-to-door. And into the places that need it most. Looks of these places, the roads are really really bad, and you have to be ready to sleep in the vehicle of the car breaks down.

The twists and turns keep coming. The African continent has challenges. The issue of getting access. to a vaccine actually involves a lot of moving pieces. There are so many things that could go wrong. And we discover how it takes a village to get our shot at history. I want to spread the message about malaria all over the world. A shot at history was produced by Amy Rose from Fix the News

with sound designed by Anthony Badalato from Hear That. This series is our first big piece of original reporting and was made possible thanks to our paying subscribers at Fix the News. We are proudly independent and subscriber funded. We also couldn't have done this without the generous support of the Postcode Lottery Group. Thank you. There were so many people who lent us a hand along the way. You know who you are at the World Health Organization, Garvey, PATH, the Ministries of Health in Kenya and Sierra Leone, the Clinton Foundation, Deutsche Vetter and Audio Craft.

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