Do we still need a malaria vaccine?

An unexpectedly large reduction in the burden of malaria has recently been achieved in a number of malaria endemic countries following the scaling up of effective treatment and simple vector control programmes. These achievements question the need for a partially effective malaria vaccine targeted at disease prevention. If an anti-disease vaccine is to replace or supplement existing control measures a high level of efficacy, sustained over a number of years, will be required. Recent successes in malaria control have re-awakened interest in the possibility of malaria elimination in areas where this was not previously considered to be a feasible objective. Malaria vaccines with transmission-blocking properties could play a key role in future elimination programmes.