Expanding Access to Life-Saving Tools

WHO-recommended malaria interventions are increasingly integrated into national health systems. Since the historic approval of the first malaria vaccine in 2021, 24 countries have incorporated it into their routine immunization programs, offering a crucial layer of protection, particularly for children. Seasonal malaria chemoprevention (SMC), a strategy of administering antimalarial medication during peak transmission seasons, has also expanded dramatically, reaching 54 million children in 2024 – a substantial increase from approximately 0.2 million in 2012.

Elimination Efforts Gain Momentum, But Face Setbacks

Despite the overall increase in cases, progress towards malaria elimination continues in specific regions. To date, 47 countries and one territory have been officially certified malaria-free by WHO. Cabo Verde and Egypt achieved this milestone in 2024, joined by Georgia, Suriname, and Timor-Leste in 2025. However, the global picture remains concerning. An estimated 282 million malaria cases and 610,000 deaths occurred in 2024 – a rise of roughly 9 million cases compared to the previous year.

The vast majority – 95% – of malaria-related deaths occur in the WHO African Region, disproportionately affecting children under the age of five. This underscores the urgent need for sustained and targeted interventions in the most vulnerable populations.

The Growing Threat of Antimalarial Drug Resistance

A critical challenge to malaria control is the escalating threat of antimalarial drug resistance. The World malaria report highlights increasing evidence of partial resistance to artemisinin derivatives, the cornerstone of malaria treatment following the failures of earlier drugs like chloroquine and sulfadoxine-pyrimethamine. Confirmed or suspected antimalarial drug resistance has now been identified in at least eight African countries, with early indications suggesting a decline in the effectiveness of combination therapies.

“New tools for prevention of malaria are giving us new hope, but we still face significant challenges,” stated Dr. Tedros Adhanom Ghebreyesus, WHO Director-General. “Increasing numbers of cases and deaths, the growing threat of drug resistance and the impact of funding cuts all threaten to roll back the progress we have made over the past two decades. However, none of these challenges is insurmountable. With the leadership of the most-affected countries and targeted investment, the vision of a malaria-free world remains achievable.”

Beyond artemisinin resistance, the spread of parasites with pfhrp2 gene deletions is undermining the reliability of rapid diagnostic tests, while pyrethroid resistance – confirmed in 48 countries – is diminishing the effectiveness of insecticide-treated nets. The emergence of Anopheles stephensi mosquitoes, resistant to many common insecticides, in nine African countries poses a particularly serious threat to urban malaria control.

Climate Change and Conflict Exacerbate the Crisis

The challenges extend beyond biological factors. Extreme weather events, driven by climate change, are altering mosquito habitats and transmission patterns, leading to increased outbreaks. Furthermore, conflict and instability in affected regions disrupt health services, limiting access to diagnosis and treatment.

The global malaria response is also hampered by a plateau in funding. In 2024, US$3.9 billion was invested, falling far short of the US$9.3 billion target set by the Global technical strategy for malaria 2016-2030. Recent cuts in Official Development Assistance (ODA) have weakened health systems, hindering surveillance efforts and increasing the risk of stock-outs of essential interventions.

What innovative financing mechanisms could be implemented to ensure sustainable funding for malaria control and elimination programs?

Dr. Martin Fitchet, CEO of Medicines for Malaria Venture, emphasized the need for new therapeutic approaches: “The World Malaria Report is clear: drug resistance is advancing. Our response must be equally clear – new medicines with new mechanisms of action.” He highlighted the development of Ganaplacide-Lumefantrine, the first non-artemisinin combination therapy, as a promising step towards building malaria resilience.

Political commitment, translated into concrete resources and actions, is crucial. WHO urges malaria-endemic countries to uphold their commitments outlined in the Yaoundé Declaration and to unite under the Big Push initiative to mitigate current and future threats.

Frequently Asked Questions About Malaria