Prof Sir Brian Greenwood has dedicated his life to the fight against malaria. Photo: London School of Hygiene and Tropical Medicine
Prof Sir Brian Greenwood has dedicated his life to the fight against malaria. Photo: London School of Hygiene and Tropical Medicine
Prof Sir Brian Greenwood has dedicated his life to the fight against malaria. Photo: London School of Hygiene and Tropical Medicine
Prof Sir Brian Greenwood has dedicated his life to the fight against malaria. Photo: London School of Hygiene and Tropical Medicine

How a British doctor helped to make malaria vaccines a reality


Nicky Harley
  • English
  • Arabic

When two newlywed British doctors started their careers in Africa, little did they realise their work to find out what was killing hundreds of young children would lead to millions of lives being saved.

Prof Sir Brian Greenwood and his wife Alice, a paediatrician, witnessed a large number of infant deaths and this set him on a path towards the creation of the world’s first malaria vaccine, and the first approved vaccine against a human parasitic disease.

After four decades of work dedicated to the fight against malaria, last year the world’s first vaccine against the disease was developed and given to millions of children.

Sir Brian, who is now 85 and a research and teaching professor at the London School of Hygiene and Tropical Medicine, found that the main reason children in Africa were dying was the mosquito-borne disease.

His interest in malaria was first sparked when he went to Nigeria in 1965 after graduating in medicine in the UK, and worked as a registrar at University College Hospital, Ibadan.

We have waited over three decades for a vaccine to be approved and now we have two in the space of a few years
Sir Brian Greenwood

While carrying out research for his thesis he discovered that there were very low incidences of autoimmune diseases among Nigerians, and he wondered if this could be linked to their repeated exposure to malaria.

He returned to the UK to continue training in immunology and was given the chance to help start a new medical school at Ahmadu Bello University in Zaria, in northern Nigeria, in 1970.

Prof Sir Brian Greenwood conducts research surveys with his wife Alice in Farafenni, Gambia, in 1983. Photo: Prof Sir Brian Greenwood
Prof Sir Brian Greenwood conducts research surveys with his wife Alice in Farafenni, Gambia, in 1983. Photo: Prof Sir Brian Greenwood

'Our initial lab was in the kitchen'

Not long afterwards the couple witnessed something they had not encountered before as hundreds of people were affected over a short period of time.

“One day we had one or two cases, the next day five cases of meningococcal, going up to 50 cases a day in a small hospital. We did a census to see what was actually killing the children,” he said. “At that time the mortality was about 300 in every 1,000, three in 10 children were dying.

“We had to find out what was going on and because there was no death certification, we thought of using postmortem questionnaires [with relatives of the dead].

“It was quite emotional. They were telling you what had happened, what the symptoms were, so we were able to build up a picture.

“There were two things they were dying of: pneumonia from chest infections and malaria.”

Prof Sir Brian Greenwood tests the Pedojet injector gun for vaccines in northern Nigeria in 1975. Photo: Prof Sir Brian Greenwood
Prof Sir Brian Greenwood tests the Pedojet injector gun for vaccines in northern Nigeria in 1975. Photo: Prof Sir Brian Greenwood

It was there that he set up the lab, initially in a kitchen, to begin researching malaria.

“It was tough as the [civil] war was just over, it was completely different from the big teaching hospitals,” Sir Brian said.

“We didn’t have many resources. Our initial lab was in the kitchen but we did get an immunology lab eventually.

“We were seeing what the immune system would do and we showed that actually if you had malaria your vaccines don’t work so well, because malaria was suppressing the immune response.

“My wife began administering drugs to young children to help prevent malaria, to see if it would make a difference.”

Two key breakthroughs

After 15 years the couple moved to Gambia, where he took up the post of director of the UK Medical Research Council Laboratories.

There he established a research programme focused on some of the most important infectious diseases prevalent in the region at that time, including malaria.

It was here that Sir Brian, who was knighted for his work in 2012, made two major breakthroughs in malaria protection.

He and his colleagues demonstrated the effectiveness of insecticide-treated nets in reducing child deaths and showed how net distribution could be incorporated successfully into a national malaria control programme.

“I set up two new field stations in the rural areas where we could start looking at malaria,” he said.

“I suddenly noticed that everybody in this rural village seemed to have a mosquito net, and that was not the case in the villages in Nigeria.

“We thought, 'Do people use the net to stop getting bitten, would it stop you getting malaria?'

“It was not a new idea as it had been used in colonial times, but then we looked at the literature to see if anybody had ever actually proven that that was the case, that having a bed net does protect you from malaria.

“And it does, so we started doing a study to show it did.

“Then people found a way to incorporate the insecticides into the nets and it was eventually picked up by the World Health Organisation.”

Malaria vaccine – in pictures

Another breakthrough followed when his team were able to show that mortality rates in young children from malaria could be reduced by giving them preventive drugs just a few months before the mosquito season.

“We had the idea that if expat children are protected then why don’t we do that for African children as well,” Sir Brian said.

“It seemed crazy if they were dying from malaria why we were not doing that.

“There was a lot of resistance in the 1980s because people were worried about resistance coming and they thought malaria prevention should only be for tourists and expats.

“My wife had been using drugs to help children not get malaria because she knew my children never had malaria, because they took their tablets.

“We started doing studies with malaria prevention in young children following on from what we had done in Nigeria and we showed that it really did work.”

Vaccine successes

Their work has paved the way for the preventions we see today.

In 1996, Sir Brian returned to the UK to take up an appointment at the London School of Hygiene and Tropical Medicine, where he continued his research on meningitis, malaria and pneumonia in West Africa.

He continued to build on the study in Gambia and conducted more trials, giving seasonal malaria prevention in Burkina Faso, Mali and Senegal.

It was a success and the results supported the earlier study’s findings.

This led to a recommendation from the WHO for preventive medicines in countries of the Sahel and sub-Sahel, with more than 30 million children now receiving the drugs each year.

Sir Brian then worked on the design of the first GSK malaria vaccine RTS, S, which in 2021 became the world's first malaria vaccine and the first approved vaccine to battle a human parasitic disease.

Prof Sir Brian Greenwood with the RTS,S malaria vaccination team in Burkina Faso in 2018. Photo: Prof Sir Brian Greenwood
Prof Sir Brian Greenwood with the RTS,S malaria vaccination team in Burkina Faso in 2018. Photo: Prof Sir Brian Greenwood

The first trials' success led to a pilot programme and now it has finally been recommended by the WHO to be used as a seasonal vaccine in countries of sub-Saharan Africa with a high malaria risk.

More than two million children have been given the vaccine and deaths in the affected areas have so far been cut by 13 per cent.

His work has shown that when a seasonal vaccination was combined with chemoprevention drugs it provided a very high level of protection to children over the first five years of their lives.

The results from this study have also helped the development of the second malaria vaccine, called R21, which was introduced last year and has many similar properties to RTS, S.

Despite the breakthroughs, Sir Brian’s biggest regret is that it took too long.

In 2022 the disease caused more than 600,000 deaths, nearly all in young African children, but the new vaccines that are now rolling off the production lines can finally spare millions of lives.

“There are lessons to be learnt,” Sir Brian said. “Ten years ago when Ebola broke out in Sierra Leone I was asked to help out with a vaccine and we did that in five years.

“Malaria is much more complicated but it should not have taken 30 years.

“Looking at where the gaps were and how it could be speeded up helped create the second vaccine, R21, and it benefitted from the experience in developing the first one.

“We have waited over three decades for a vaccine to be approved and now we have two in the space of a few years.

“But it is not a silver bullet. More research is needed to create a vaccine that can offer longer protection. That is the next step now.”

'It was a team effort'

Despite his work in helping to develop the vaccines, Sir Brian's greatest achievement remains training the next generation of scientists in Africa to continue the fight against malaria.

In 2001, he received a large grant to the London School of Hygiene and Tropical Medicine from the Bill and Melinda Gates Foundation to set up the Gates Malaria Partnership, which supported the training in research of 40 African PhD students and postdoctoral fellows.

Sir Brian became the director of its successor programme, the Malaria Capacity Development Consortium, in 2008.

Professor Sir Brian Greenwood has trained the next generation of scientists in Africa to continue the fight against malaria. Photo: Mark Henley / WHO
Professor Sir Brian Greenwood has trained the next generation of scientists in Africa to continue the fight against malaria. Photo: Mark Henley / WHO

It was funded by the Wellcome Trust and the Bill and Melinda Gates Foundation, which supported a postgraduate malaria training programme in five universities in sub-Saharan Africa.

“We have to keep up the funding. For the last eight years I have been chair of a WHO elimination commission to certify countries which have eliminated malaria and I send out teams to see if it is really true.

“Since we set this up, about 15 countries have been certified as having eliminated it.

“This year Cape Verde and Georgia are on the list. Gradually the map is shrinking but more needs to be done.”

A mosquito feeds on a human host. Sir Brian and his colleagues demonstrated the effectiveness of insecticide-treated mosquito nets in reducing child deaths. Getty Images
A mosquito feeds on a human host. Sir Brian and his colleagues demonstrated the effectiveness of insecticide-treated mosquito nets in reducing child deaths. Getty Images

After his achievements in the battle against malaria, Sir Brian was awarded his knighthood in the UK's honours list.

“It was a team effort,” he said. “I could have ended up in Harley Street and had a big house in the south of France but I have absolutely no regrets.”

Did you know?

Brunch has been around, is some form or another, for more than a century. The word was first mentioned in print in an 1895 edition of Hunter’s Weekly, after making the rounds among university students in Britain. The article, entitled Brunch: A Plea, argued the case for a later, more sociable weekend meal. “By eliminating the need to get up early on Sunday, brunch would make life brighter for Saturday night carousers. It would promote human happiness in other ways as well,” the piece read. “It is talk-compelling. It puts you in a good temper, it makes you satisfied with yourself and your fellow beings, it sweeps away the worries and cobwebs of the week.” More than 100 years later, author Guy Beringer’s words still ring true, especially in the UAE, where brunches are often used to mark special, sociable occasions.

UAE currency: the story behind the money in your pockets
Basquiat in Abu Dhabi

One of Basquiat’s paintings, the vibrant Cabra (1981–82), now hangs in Louvre Abu Dhabi temporarily, on loan from the Guggenheim Abu Dhabi. 

The latter museum is not open physically, but has assembled a collection and puts together a series of events called Talking Art, such as this discussion, moderated by writer Chaedria LaBouvier. 

It's something of a Basquiat season in Abu Dhabi at the moment. Last week, The Radiant Child, a documentary on Basquiat was shown at Manarat Al Saadiyat, and tonight (April 18) the Guggenheim Abu Dhabi is throwing the re-creation of a party tonight, of the legendary Canal Zone party thrown in 1979, which epitomised the collaborative scene of the time. It was at Canal Zone that Basquiat met prominent members of the art world and moved from unknown graffiti artist into someone in the spotlight.  

“We’ve invited local resident arists, we’ll have spray cans at the ready,” says curator Maisa Al Qassemi of the Guggenheim Abu Dhabi. 

Guggenheim Abu Dhabi's Canal Zone Remix is at Manarat Al Saadiyat, Thursday April 18, from 8pm. Free entry to all. Basquiat's Cabra is on view at Louvre Abu Dhabi until October

Key facilities
  • Olympic-size swimming pool with a split bulkhead for multi-use configurations, including water polo and 50m/25m training lanes
  • Premier League-standard football pitch
  • 400m Olympic running track
  • NBA-spec basketball court with auditorium
  • 600-seat auditorium
  • Spaces for historical and cultural exploration
  • An elevated football field that doubles as a helipad
  • Specialist robotics and science laboratories
  • AR and VR-enabled learning centres
  • Disruption Lab and Research Centre for developing entrepreneurial skills
Conflict, drought, famine

Estimates of the number of deaths caused by the famine range from 400,000 to 1 million, according to a document prepared for the UK House of Lords in 2024.
It has been claimed that the policies of the Ethiopian government, which took control after deposing Emperor Haile Selassie in a military-led revolution in 1974, contributed to the scale of the famine.
Dr Miriam Bradley, senior lecturer in humanitarian studies at the University of Manchester, has argued that, by the early 1980s, “several government policies combined to cause, rather than prevent, a famine which lasted from 1983 to 1985. Mengistu’s government imposed Stalinist-model agricultural policies involving forced collectivisation and villagisation [relocation of communities into planned villages].
The West became aware of the catastrophe through a series of BBC News reports by journalist Michael Buerk in October 1984 describing a “biblical famine” and containing graphic images of thousands of people, including children, facing starvation.

Band Aid

Bob Geldof, singer with the Irish rock group The Boomtown Rats, formed Band Aid in response to the horrific images shown in the news broadcasts.
With Midge Ure of the band Ultravox, he wrote the hit charity single Do They Know it’s Christmas in December 1984, featuring a string of high-profile musicians.
Following the single’s success, the idea to stage a rock concert evolved.
Live Aid was a series of simultaneous concerts that took place at Wembley Stadium in London, John F Kennedy Stadium in Philadelphia, the US, and at various other venues across the world.
The combined event was broadcast to an estimated worldwide audience of 1.5 billion.

While you're here
Updated: June 21, 2024, 6:34 PM`