Dr. Elias Rejoice
Maynard Phiri

Malaria still kills more than 600,000 people every year, and over 94% of those deaths occur in Africa. It remains a disease of the poor — thriving where health systems are underfunded and communities have little political power. While prevention tools have expanded — from insecticide-treated nets to chemoprevention and now vaccines — a new option has entered the scene: monoclonal antibodies (mAbs). Early trials show they work extremely well and could reshape malaria prevention.

But promising technologies don't automatically reach the people who need them. These systems are shaped by global power imbalances — in pricing, regulation, priority-setting, and who controls the money.

This challenge is becoming sharper. Donor funding is shrinking, and recent cuts — including major reductions in US global health support — have exposed how dependent many malaria programmes are on external financing. Countries like Kenya now face a difficult question: in a world of declining aid and shifting geopolitical pressures, how can a health system make sovereign, evidence-based decisions about adopting a new but costly technology?

This issue sits squarely within the HSR 2026 theme on Politics and Polycrises, and speaks directly to the broader push for future-ready, resilient health systems.

My Approach: As part of my PhD, I am conducting a mixed-methods case study on the feasibility of introducing monoclonal antibodies for malaria prevention in Kenya. I compare mAbs with existing tools — chemoprophylaxis and vaccines — across affordability, supply chains, workforce capacity, regulatory processes, political economy, and community acceptability.

The work draws on policy documents, interviews with decision-makers and health workers, and assessments of health facilities. My aim is to generate evidence rooted in Kenya's real institutional context, not donor expectations.

Ultimately, I want to help shift how LMICs engage with new health technologies — from passive recipients to informed, confident negotiators. Researchers from the Global South should be leading these conversations, not sitting on the margins.

EV4GH is the kind of space that strengthens that voice, and I hope to contribute to a more equitable and sovereign future for health systems like Kenya's.