An unprecedented mobilisation of the international community to fight malaria, as well as massive investments since the beginning of the century have allowed cutting by half the mortality rate of the disease globally. Between 2000 and 2021, the number of countries with fewer than 10 indigenous cases increased from 4 to 25.

Yet, since the Covid-19 pandemic, the number of malaria cases and deaths is increasing, and 50% of the world population is at risk.

A Future Free of Malaria for Children in Viet Nam

In 2022, 249 million cases and 608,000 deaths were recorded, up significantly from the 233 million cases and 576,000 deaths recorded three years earlier.

The Africa region accounts for 95% of all cases and deaths globally. Four countries, Nigeria, the Democratic Republic of the Congo, Uganda and Mozambique, account for almost half of them.

Among the 608 000 deaths reported, 76% were in children under 5. Every minute, a child dies of malaria.

An array of factors are behind the rise in malaria cases: Behavioural changes among malaria-carrying mosquitoes, together with the spread of resistance to insecticides and treatments, stand out as prime factors behind the intensification of the malaria pandemic. Climate change has also direct and indirect effects on malaria: the massive flooding in Pakistan in 2023 led to 2,1 million additional malaria cases.

Gender inequalities hinder access to prevention and care. Reaching out to the most vulnerable, particularly to displaced people, is a major factor of success against malaria, as is against all other epidemics.

Progress against the disease were achieved thanks to massive vector control efforts, either through indoor residual spraying (IRS) or the distribution of long-lasting mosquito nets impregnated with insecticide (ITNs), diagnosis tests, and Artemisinin-based combination therapies (ACT). While research for the development of an antimalarial vaccine is encouraging and would add a new tool to the existing arsenal to fight the disease, its development and provision to all populations in need is not yet at a wide use stage.

The WHO has authorised at the end of 2023 the use of two vaccines, RTS,S and R21, both recommended for children five months and older. Although not a magic bullet that can end malaria on their own, vaccines will nonetheless save lives when combined with other vector control tools.

2022 investments in malaria programmes came to only USD 4.1 billion, well below the USD 7.8 billion required (and the target of USD 9.3 billion for 2025). Moreover, research and development spending was a mere USD 608 million, the lowest level in the past 15 years.

The Global Fund alone provides 65% of international funding for malaria programmes. Its integrated approach enables all stakeholders – national governments, the private sector, communities, international organisations and NGOs – to work together to adopt the best possible response to malaria in the countries where the Fund operates. It also allows greater access to innovations such as next-generation ITNs.

© William Daniels