At the end of April, health workers in Malawi, Ghana and Kenya began rolling out the first and so far only vaccine proved to protect against malaria. It’s part of a World Health Organization pilot programme that could immunise more than one million children by 2023. Yet, while this is a welcome step in the fight against malaria, it also exposes the problems in developing vaccines for use in non-western countries.

This kind of endeavour can’t be repeated, from GSK’s point of view GlaxoSmithKline

The vaccine, called RTS,S, prevents malaria in only 40% of cases. It has taken more than 30 years to develop and cost more than $700m. The manufacturer, GlaxoSmithKline, proclaimed itself “incredibly proud to see it rolled out”, but added: “This kind of endeavour can’t be repeated, from GSK’s point of view.” That’s because all drug research and development is based on a model of a multinational charging high prices for products tailored to wealthy markets. As there is little incentive for pharmaceutical companies to conduct R&D for diseases that affect populations with limited purchasing power, a report for Oxfam and Médecins Sans Frontières observes, so “some diseases continue to be unaddressed by vaccines altogether, while many vaccines are not well-adapted for people in developing countries”.

There are about 240 vaccines in early stages of development for diseases that predominantly affect people in non-western countries. Yet only a handful have in recent years made it through the pipeline for use in low-income countries. It’s an indictment of a system in which profit talks but needs are neglected.

• Kenan Malik is an Observer columnist