But until recently, the world’s smallest and most vulnerable malaria patients had no approved treatment designed specifically for them. Improvised dosesFor decades, healthcare workers treating malaria in newborns faced an impossible choice — use adult medications at improvised doses and risk causing harm or avoid treatment altogether in the most vulnerable patients. Several factors contributed to this decades-long gap in paediatric malaria care. “This isn’t going to be a blockbuster drug,” Aspinall acknowledged, “but it is a public health necessity. It’s unacceptable, but it’s our reality.”The approval comes as malaria vaccines like RTS,S and R21 are being rolled out across Africa.