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On World Malaria Day, the spotlight turns once again to one of the world’s oldest and deadliest diseases. This year, the story feels different. For decades, the malaria vaccine was seen as the breakthrough the world was waiting for. Now it’s here. So why does the fight against malaria still feel unfinished?

In this episode, I speak with Photini Sinnis, a professor at the Johns Hopkins Bloomberg School of Public Health and a leading expert on how malaria infection begins in the body.

We unpack what the arrival of malaria vaccines really means—and what it doesn’t. Why these vaccines were never meant to be a “magic bullet.” Why bed nets, drugs, and vector control still matter. And why combining tools, rather than relying on one breakthrough, may be the only realistic path forward.

We also go deeper into the science: the hidden complexity of the malaria parasite, the push toward multi-stage vaccines, and the knowledge gaps that still define this field. Along the way, we confront a harder truth—why global health innovation doesn’t always move at the same speed for every disease.

There is real progress. There is renewed optimism. But there is no simple solution.

This is the malaria paradox: more tools than ever before, yet a fight that is far from over.