On World Malaria Day, Africa finds itself at a critical crossroads in the fight against one of its most deadly health challenges. While progress has been made in reducing the burden of malaria, the disease continues to pose a significant threat, particularly to the youngest members of society.
A Steady Increase in Cases
According to the 2024 World Malaria Report, malaria cases rose sharply by approximately 11 million, bringing the total number of cases to an estimated 263 million globally, with the majority occurring in Africa. Despite global efforts to combat the disease, deaths remained high, with 597,000 malaria-related fatalities in 2023—a figure that has remained largely stable over the past few years. Sub-Saharan Africa is the hardest-hit region, with 95% of global malaria cases and 96% of deaths reported in this part of the world.
The Impact on Children Under Five
Among the hardest hit by malaria are children under five years old, who remain the most vulnerable group. In Nigeria, nearly 40% of global malaria deaths in this age group occurred in 2023, underscoring the disproportionate impact malaria continues to have on Africa’s youngest. This devastating statistic highlights the urgent need for stronger interventions and improved health systems, particularly in countries with the highest burden.
Challenges to Malaria Control
The road to malaria control has not been without setbacks. The COVID-19 pandemic exacerbated many of the challenges to malaria prevention and treatment, setting back progress by disrupting health systems, increasing vaccine delivery delays, and reducing access to essential treatments. “In the wake of the COVID-19 pandemic, many countries continue to grapple with challenges to malaria control, including fragile health systems, weak surveillance, and chronic funding shortfalls,” said Dr. Tedros Adhanom Ghebreyesus, Director-General of the World Health Organization (WHO) in the report.
One of the most significant emerging threats in the battle against malaria is the invasion of Anopheles stephensi, a mosquito species that thrives in urban environments. This new species has been found in several African cities, compounding the difficulties of controlling the spread of the disease. Additionally, the spread of antimalarial drug resistance poses a growing challenge, as drugs become less effective in some regions.
Technological Innovations
Despite these challenges, there have been significant strides in developing new tools to fight malaria. Technological advances, such as vaccines and long-lasting insecticide-treated nets (LLINs), have shown considerable promise in reducing the disease burden. The RTS, S malaria vaccine, which has been deployed in several African countries, is the first malaria vaccine to have shown a reduction in malaria cases and deaths in children.
Dr. Tedros emphasized, “Technological advances hold the promise of further gains,” particularly with the R21/Matrix-M malaria vaccine, which has shown even higher efficacy than RTS, S in clinical trials.
LLINs continue to be the most cost-effective tool for malaria prevention. The WHO reports that widespread use of these nets has contributed to a 50% reduction in malaria incidence in several African regions. These nets, combined with other interventions like indoor residual spraying, remain critical in the ongoing fight to reduce malaria transmission.
Funding Challenges
One of the most pressing issues highlighted in the report is the chronic funding shortfall in the global fight against malaria. In 2023, about $4 billion was allocated to malaria control efforts, but the report notes that an estimated $8.3 billion is required annually to meet the 2030 targets for malaria elimination. The financial gap makes it challenging for countries, especially those in Africa, to sustain and expand malaria control programs.
The report stresses the need for increased global funding and domestic financing for malaria control, calling on both international donors and African governments to step up their commitments. While the Global Fund has played a crucial role in providing financial support, the report notes that “increased domestic funding is essential for the long-term sustainability of malaria programs.”
Progress Amidst Adversity
While the malaria situation in Africa remains dire, some countries have made impressive progress. Ethiopia, Tanzania, and Rwanda have reduced malaria incidence through sustained and targeted interventions, particularly in areas with high transmission rates. These countries’ successes provide valuable lessons in tackling malaria at the national level, and their experiences can serve as models for other African nations grappling with the disease.
The WHO remains hopeful, emphasizing that “While progress has been made, the challenge remains formidable.” The report calls for urgent action and greater international cooperation to accelerate malaria control efforts and avoid further setbacks.
Looking to the Future
The future of malaria control in Africa is uncertain, but the ongoing work of global health organizations, national governments, and local communities offers a glimmer of hope. Continued investment in malaria control technologies, coupled with strengthened health systems and increased funding, can pave the way toward a malaria-free Africa. As Dr. Tedros concludes, “Technological advances hold the promise of further gains,” reinforcing the need to harness these innovations to achieve the Sustainable Development Goal (SDG) of ending malaria by 2030.
