Hope Is A Verb - A Shot At History, Part 3 - The Jab

Episode Date: September 26, 2025

In our final episode of the series, we’ll uncover the surprising stories behind the science of the world’s first jab for malaria and how this ‘orphan’ vaccine became a lifesaving intervention that has already reached 5 million children. We look at what's next for the malaria vaccine, the threats of funding cuts to global health and answer the big question – is it working? Here’s who you’ll meet:Angus Hervey: Founder of Fix The NewsTeresa Chirwa-Ndanga: Journalist & human rights activist, MalawiDr Joe Cohen: Project Lead, Malaria Vaccine at GlaxoSmithKline BiologicalsDr Mehreen Datoo: Clinical research fellow-Malaria vaccine trials, Oxford UniversityJohn Bawa: Director, Malaria Vaccine Implementation, PATH.Dr Scott Gordon: Head of Gavi's Malaria Program A Shot At History is produced by Fix The News. Series Producer, Amy Davoren-Rose, Fix The News. Associate Producer & Audio Director, Anthony Badolato, Hear That?

I've been obsessed with the malaria vaccine for years. I guess maybe it's personal. I was born and raised in South Africa and I've spent more than half my life in Africa, traveling, working. So, of course, I know about malaria, but I don't know malaria. It's never been a danger to me. My body was burning. I thought I was going to die. Honestly, I thought I was going to die.

What I do understand is how dangerous. It is how it stalks children in the night. The situation was pretty dire. Tragically, children would die, waiting in line to be seen. This story has ended up being so much bigger than we could ever have imagined. I want to spread the message all over the world. The stakes are staggering. Every day, 1,000 children.

This should be a firestorm of concern everywhere in the world. That statistic, a thousand kids a day, I can't get it out of my head. But now this miraculous vaccine has arrived. It's such a monumental, sprawling challenge. If we miss just one step, the whole chain will just collapse. There are so many ways it can fall apart. The roads are really bad and you have to be ready to sleep in the vehicle of the car breaks down.

The logistics are insane. The dedication is overwhelming. Our initial is to save lives. Everything about religion is to save life. We encourage them that when the vaccine come, they give the children. Millions of kids have already had a shot, and we know it works. Children who were vaccinated had a reduction in severe malaria by 50%. It's one of the biggest projects in global health.

Maybe one of the most important things happening in the world right now. And the crazy thing is that it might never have happened at all if it wasn't for one stubborn scientist tinkering away in a lab. I'm Gus Harvey, and this is a shot at history, episode three, The Jab. When I started working on it, the project was tolerated. There were a few people who were supportive, but many who weren't. Very little support in terms of resources.

We had to work almost underground. This is Dr. Joe Cohen. Science to me had become a vocation. I liked the process of science, and I wanted to see results and get answers to questions. As long as I worked in the lab, I always worked late and on weekends. In 1984, he started working at Smith-Kline and French in Brussels,

today part of the pharmaceutical giant, Glaxo-SmithKline. It was his first real science job at the age of 40, where he inherited a project that nobody else wanted. It was a small team that wasn't getting enough support from the higher-ups. We were pushing each other, essentially, to keep going. there was the added motivation that this was a vaccine that was potentially save hundreds of thousands, if not millions of lives. A little bit of context here. Malaria is old. It's been one of humanity's deadliest enemies for millennia. Recent DNA analysis, for example, suggests that it was what killed the boyfarer, Tutankhamen.

It's a disease that has evolved with us each step of the way throughout human history. for centuries it's outwarded our best scientific minds many have tried to figure out a way to stop it all of them have failed but that didn't stop Joe and his small team from trying first of all I'd like to say that things appear very complicated when you haven't solved them yet after you solve them they looked like

well it wasn't that complicated but yes there were big scientific issues You have to remember that this parasite takes many different forms. The malaria parasite is sneaky. It's evolved to hide from our immune system. In fact, for a long time, scientists thought malaria didn't even trigger an immune response. That's one of the reasons that creating a vaccine has been so hard, because vaccines work by showing your immune system a wanted poster of the disease,

so your body knows what to attack. But malaria, well, it's constantly changing, shape. It's like trying to catch smoke. So I didn't come into the lab in a complete void. Science is always a progressive process. Many scientists had been trying to figure out which part of that parasite could be used in a vaccine. And a couple of scientists at NYU had actually found that a particular protein called the CSP, the circumsworthide protein, could be a good target. Dros talking about Ruth and Victor Notion Schwein.

Two Austrian scientists who escaped the Nazis in the 1940s and emigrated to Brazil and then the United States. Their work, especially Ruth's, proved foundational in the quest to develop a vaccine. Here's a clip of Ruth speaking. When we started our research approximately 20 years ago on a malaria vaccine, the development of such a vaccine appears. it to be a very difficult task. When I came on board, we really believed that the CSP was a good antigen.

And we had some good ideas about how to present that antigen to the human immune system. One was to try to present this protein in the form of a particle. It would look like a virus. So Joe picks up where Ruth and Victor had left off. They had managed to identify a key protein in the parasite, but nobody could. could get the immune system to actually notice it. Joe was the one who figured it out. He had worked on hepatitis B vaccines before,

so he took what he'd learned and did something clever. He linked genes from hepatitis B with the malaria parasite, creating virus-like particles. And when our immune system sees something that looks like a virus, it knows exactly what to do. Think of those COVID-19 graphics. Remember those spiky balls? Well, Joe's team created something similar.

Blobs with a coating of hepatitis B and malaria proteins studded around them like cloves on an orange. That studded orange became RTSS, the world's first malaria vaccine. Two moments were incredibly exciting. The first one is 1995-96, when a number of volunteers were immunized with our candidate vaccine and seven out of eight were actually protected. And that was completely unheard of. The second big eureka moment was in 2004 when we conducted a study in Mozambique

in young African children under regular conditions. And we observe for the first time efficacy in young African children. And that moment is printed in my mind and I have a picture of several of us sitting around the table in a position of prayer listening through what the statisticians

were telling us. That moment is just unforgettable. I have a chills thinking about it. Almost 20 years after he started tinkering in that Brussels lab, Joe finally gets the news he's been waiting for. The vaccine works.

But it would take another 15 years before the World Health Organization gave approval. So we're talking about a 34-year journey from orphaned vaccine to global rollout. I asked Joe why it took so long. Yes, 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. This was not a simple project. It involved young infants and children in Africa, and we proceeded very carefully from adults to adolescents, young children, toddlers, and then babies. I mean, it's really fortunate to have had this incredible opportunity to work on something from almost its beginning to actually see it coming to an end, especially something like a vaccine that saves lives.

While Dros' vaccine was grinding through trials in Mozambique, in the United Kingdom, another group of scientists were hard at work on a second vaccine. This is Marine Data, who is part of the team working on this second vaccine, R21. The R21 vaccine has been in development since 2011. It was produced by a PhD student, Catherine Collins, at the General Institute, under the supervision of Professor Sir Adrian Hill. Our vaccine tries to target malaria very early on, but contains a higher proportion of the malaria protein compared to RTSS.

Essentially, what they did was to add more studs to Joe's Orange. The theory was simple. More malaria antigens should trigger a stronger immune response. Marine's job was to run the early trials, deliberately infecting healthy volunteers to test whether this new approach worked. I love to give people malaria, which sounds weird, but understandably it's in a very safe and controlled environment. So basically we give participants vaccines and they get five infectious mosquito bites. It sounds pretty simple getting mosquito bites, but it's not actually

that quick or simple. Just help me understand this, right? So you put out an advert and someone walks in and says, hi, I'm here to volunteer. And then what do you do? You stick them in a room with mosquitoes and wait for them to get stung. If only, it was a simple process. Just to say, malaria challenge trial is usually one to two years in the planning. Our mosquitoes come from the Walter Reed Army Institute in America. They are specially bred with a fully sensitive strain of malaria that we know we can definitely treat. They're flown in a special contained box in first class. It's too cold for mosquitoes to go in the car guy. And they can. come here to customs at Heathrow Airport, and I am literally tracking mosquito flights on my phone.

In terms of the actual challenge, participants will have had a vaccine regime, and about a month after their last vaccine, they undergo malaria challenge. It is small numbers of participants, and it's all about the relationships we develop, because we end up seeing them so much. We see them for all their vaccines, and we spend whole days together. We all travel together to London on the train. We use the Insectry at Imperial College, and we have a small room, which is the biting room, and five mosquitoes are basically placed in a simple coffee cups from the cafe downstairs,

and there's a little net put over it, and then a cup is placed on a participant's arm for five minutes. And we wait for the mosquitoes to bite. However, we only give each cup five minutes, because if they've not bitten you within five cups, those mosquitoes are not likely to bite. I have to say, I think in the five challenges I've done, I've only ever had a one-cup wonder. When you picture vaccine development, you probably don't imagine mosquitoes flying first class

or people with coffee cups taped to their arms. But that's science for you. Equal parts, bizarre and brilliant. I have to admit, this whole process that marine describing kind of blew me away. I had to know, what makes a group of healthy people in the United Kingdom sign up for trials for a brand new vaccine for a disease that will never affect them? They care, they care about humanity, they care about the wider world,

they appreciate that they have the opportunity to help other people. They give up a lot of time to take part in a malaria challenge. and if you didn't care about other people, other diseases, other countries, you wouldn't do that. Throughout this series, Teresa has been our guide, our eyes and ears on the ground in Africa. So I was really interested to find out how she felt listening to all of these people that had been involved in the development of the vaccine. I honestly didn't know. No, the amount of effort that has been put into getting the malaria vaccine out in the field to the kids that need it.

Personally, I don't know if I would be that invested for years. Especially if that problem is not mine, trying to make a difference in someone's life when it's not your problem. This is angelic, to say the list. It's just like, why do you care so much? You know, I would ask that question If I met one of those people who have been in the labs Trying to push so hard I would just love to know

You made this a purpose of your life And that's amazing The world is really this one huge village So we're getting close now It's taken a really long time But we know the vaccine works And we know it's safe We've already seen this incredible human chain

That's getting it out to communities but there are still a few more missing pieces of the puzzle. For example, what about all the paperwork, all the regulatory stuff, the logistical planning? Well, that's where people like John Bauer come in. I lost one of my siblings to severe malaria. And even though I was very young at the time, I saw the pain and the anguish that my mother went through.

So I promised myself that whenever I have an opportunity to contribute to any effort so that no matter goes through this pain again, I will do it with all effort. John works for PATH. They're one of the biggest players in global health and have been involved in this malaria vaccine story from the very beginning, partnering with GSK on the original research,

running the clinical trials, designing the pilot programs, and now helping countries figure out how to actually use it. Ideally, a country needs a minimum of one year to adequately prepare to uptake and introduce. The biggest surprise has been the huge demand. Within three to four months, you had close to 30 countries expressing interest. It really shows the trust and confidence that the entire global system has in the impact that the person can make. And as of now, over 5 million children have received at least one dose of the Malaya Vassan and it's still counted.

I just want you to take that number in. Five million children have already received at least one dose of the four-dose malaria vaccine. A child gets the most benefits if he's able to get all four doses. However, there's also evidence that if a child is able to do at least three doses, he or she get significant benefit. And so we wouldn't encourage less than three doses at the moment. And when we do this, we don't only look out for. for children who have missed a malaria vaccine,

you use that as a platform to ensure that they catch up and receive all those services that they have missed. More shots, less malaria, more touch points for the health system, less suffering, fewer deaths, easy, right? Well, not so fast. You see, each vial contains enough for two babies, but what if one of those babies doesn't arrive on time? Yet another thing you need to get right

in a very long line of things you need to get right. You need to use it within six hours of opening it. So if, let's say, no child appears within the next six hours, you have to discuss the unused file. However, you cannot wait for all children to gather before you do that. Because what it means is that a service that is starting at 8 a.m., some others will come around 7 a.m., others will come at around 3 p.m. It will be unfair to say you are waiting for everybody to come.

So what it means is that you need to account for all these wastages. And of course, the vial, it's a bottle, and it can break. If it breaks and it spells, it's an accident. So normally when we are doing the quantifications, we make another room for wastage factor for up to 25%. So we've had decades of science, incredible logistics. We've heard from the scientists in the labs and the women in the markets and the healthcare workers on motorcycles.

But after all that, all of the testing and planning and hustling, there is still one crucial question. Is it working? Is it actually making a difference? To find out, I asked Teresa to call someone who might know. Hello, can you hear me? Hello? We can hear you.

Hi, Helen. This is Helen Auro Ongo. She's a registered nurse at a maternal health clinic in Kisumu in Kenya. It's more of a remote area. We call it an endemic zone. There is no day that you leave the hospital without having a patient having a positive bloodslide for malaria. It is a disease that we see every day. She was telling me what it's like in the children's world.

The children's world is not like it used to be. For severe forms of malaria, the cases have greatly gone down. I think this is an attributable to the presence of this vaccine. So in this part of Kenya, the vaccine pilot was rolled out in 2019, and the first kids to receive the vaccine are now like six years old. So when we heard that a vaccine is coming, tools are reprieve for us, because this is what has been burdening our health system. So I ask Helen to describe a normal date in the vaccination world.

So in an annual day, it is usually really packed. The vaccination ward is packed. And because the babies are getting vaccinated, the children's ward is not packed. It's basically proof that the pilot program was a success. What Helen is describing isn't just anecdotal. It's backed up by hard data. Scott Gordon is the head of malaria programs at Garvey,

the Global Vaccine Alliance. They're the organization that has provided most of the funding for the role arts, absolutely crucial to this story. So if anyone's got the big picture on how it's going, it's him. In the pilot countries, we were able to show a reduction in all-cause mortality, about 13% in the communities where kids receive the vaccine. I'm optimistic that we'll see a situation similar to what we had reported in Kusumu, Kenya, where the director of health services in that city was saying that he was having to close down child health boards.

because they didn't have kids filling the beds for malaria. If you've been following the news, you'll know that global health has been under massive pressure recently. Cuts across the board, programs getting slashed, entire initiatives at risk. Suddenly, it seems like every program is fighting for survival. Over the last two decades, the US has been the largest, bilateral donor to the fight against malaria, helping to prevent an estimated 2.2 billion

cases and 12.7 million doses. If disruptions continue, we could see an additional 15 million cases of malaria and 107,000 deaths this year alone, reversing 15 years of progress. When we spoke to Scott, they were right in the middle of fundraising. As we all know, it's obviously a challenging time on the global health landscape, but we've had really strong initial commitments from our donor base in support of what we call our replenishment, which is raising the funds that we'll need to get more than 50 million children vaccinated with the malaria vaccine over the coming five years.

We call the malaria vaccine one of our must-win programs. That means it's a vaccine that we've really highlighted as being of critical importance for our mission in terms of improving access to vaccines. The good news is that they pulled it off. Well, mostly. In July 2025, Garvey raised over $9 billion at a major summit. Although it was short of their stretch target,

it's still enough to vaccinate 50 million kids with malaria vaccines by 2030. On the eve of the summit, the United States ambushed everyone by pulling out, but other countries and foundations stepped up. The United Kingdom was the single biggest donor, followed by the Gates Foundation. for the malaria vaccine, another obstacle overcome in a very long obstacle-filled journey. I feel like there's never an end to the surprises that we run into. I mean, we underwent the pilots right in the middle of a global pandemic.

We've had cholera epidemics. We've had health care worker strikes. We had an outbreak of polio. We've had typhoons. We've had flooding. And still, despite all of those disruptions, the vaccine kept being implemented. The biggest surprise has been how durable the vaccine has been and how much the communities have wanted it,

how the health care workers have wanted to provide it, and be able to show the impacts from that. This is obviously a much more global perspective. I wanted to know from Teresa what the relationship between donors and individual countries actually looks like from the ground up. They're a huge part of this story. Actually, we can't talk about fighting malaria

without talking about donors. If you talk about the malaria fight, I mean, starting from the tests, almost everything is funded by the donors. Yes, this is our disease, but for us to fight it, we need the support. Malawi can't even manufacture the mosquito nets. That is like a basic necessity in every home.

We can't source our own medication. You see, if we don't find a solution, we will continue to be a burden for the richer countries. And because of the interconnected nature of the problem that malaria is, it will also bring about other challenges. And we can't solve those challenges alone. That dependency, Theresa describes, it's the reality behind a lot of the global health work we've been talking about. the funding summits, the donor pledges, the careful coordination between countries and organizations. And in some ways, a lot of that can often feel kind of abstract, but not for Scott. For him, it comes down to individual faces and names.

For me, the really critical time points are when I'm in the country, when I'm in the clinics, when I'm actually seeing children being vaccinated and the impacts that it's having on those kids and on those families. going all the way back to late March of 2019 and seeing the very first child, Lusitana, being vaccinated in Malawi, and then being able to track her progress over time, seeing that she was experiencing less malaria than most of the other kids in that country,

that she's a happy and healthy primary school child. I keep going back to the names of the first kids, not because the first kids are somehow different from all the other kids that have been immunized, but for me, it personalizes the work that we are doing, and that's really important to me, and I think it's important to a lot of people to have a sense that this is not just statistics,

but it's being able to say, we've immunized children like Lusatana in Malawi and Daniel and Daniela in Cameroon with this vaccine that's kept them from getting malaria that otherwise they might have died from. Scott's connection to those children, that first generation of kids getting the vaccine,

it made me curious about future generations. I asked him what was coming next. The pace is picking up, much, much quicker now. Vaccines that can treat a broader population, the entire age group, vaccines that can address other parts of the life cycle of malaria.

We're excited about vaccines that have a longer duration of protection and perhaps ultimately providing lifelong immunity. Teresa, I just think about how many hundreds of thousands of kids are we going to save? Is one of those kids going to go on to become a great scientist or a great African leader or are they going to become like a Nigerian pop star

or an amazing Malawian fashion designer? I don't know. I think about that. I mean, the potential is huge. But to be honest with you, Gus, the immediate vision I see in my head is those empty beds in the hospital. Oh my God, we could actually get to a point where in a public facility,

we don't have kids in those beds. That in itself. Having kids playing in the dirt and just being happy and being away from all those hospital sounds, that will be amazing. So here we are. At the end of three episodes, our version, at Fix the News,

of what we think is one of the greatest stories in the world. I started this series obsessed with the vaccine, but I'm ending it thinking about something much bigger, about what it actually takes to make progress happen in a world that seems designed to crush it. Along the way, we've met some extraordinary people, not saints or superheroes, just people who refuse to accept that children

dying every day was inevitable, who believed that something better was possible, and who have been willing to spend decades proving it. That gives me so much hope. In a world where the worst kinds of people are the ones who make all the headlines, and where the future feels so much more uncertain than it used to, this vaccine just keeps on moving forward. The funding keeps coming, health workers keep showing up. The human chain keeps holding. And kids keep getting that jab. That's why millions are already protected. It's why tens of millions more will follow. And when I think about those children, running around in playgrounds instead of lying in hospital beds, growing up instead of becoming statistics, I think about how the impossible sometimes becomes inevitable

and that despite everything, all the obstacles, all the setbacks, all the reasons that It shouldn't work. Progress does still happen, one shot at a time. I'm just incredibly fortunate. That's the major feeling I have looking back at my career. I'm here because I can speak for people. And when I see that they take action, I feel very grateful that I was a part of the process.

This kind of work allows for parents to watch their children grow and live their life and for pot. That is the greatest satisfaction I could ever imagine. This takes a huge partnership. There's not a single organization or a single person that can make something like this work. People in this area, they are committed. They are passionate. This is what they want to do.

To look back at some of those kids and saying, yes, they survived because of this vaccine, but also the community is doing so much better because of the vaccine. There is hope that they must. that the malaria vaccine is going to transform livelihoods, communities. And one day, we may not be talking about malaria as a problem anymore. The rollout of the malaria vaccine will hopefully be a testament to health equity, that it matters. I think that you and I one day would say we're part of that success 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. This is the very first time in my 43 years of life that I have reflected on the malaria problem. As a journalist, sometimes you tell stories as if you have not been affected, but this helped me to reflect on my own. journey, how malaria has personally affected me as a child growing up as an adult, but also how it has affected my own children.

I have felt the fear that grapples you, and I really wish that this burden is taken off our shoulders, and mothers breathe a sigh of relief. knowing that they will not have to fight this monster of a disease and not get used to normalizing such a big disease as just part of our lives. When I think about the end of malaria, I think about how this could actually change how the world thinks about us. Maybe for once they want to just think about poverty. I see the potential because that's actually my story.

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. This story is important to us. If you enjoyed it, please share it around.