Beds nets have saved millions of children's lives from malaria since 2000.Photo/UN
By Daisy Okiring
A new World Health Organization (WHO) report has revealed that malaria drug resistance is rapidly spreading across Africa, putting global control efforts at risk despite major advances in vaccines, diagnostics and mosquito control tools. The disease caused an estimated 282 million cases and 610,000 deaths in 2024, an increase of nearly 9 million cases from the previous year.
Partial resistance to artemisinin—the cornerstone of modern malaria treatment—has now been confirmed or suspected in at least eight African countries. Pyrethroid resistance, which undermines the impact of insecticide-treated nets, has been documented in 48 countries. At the same time, the invasive mosquito species Anopheles stephensi continues to spread, reaching nine African nations and complicating malaria control in dense urban areas.
Vaccines and new tools save millions
Despite these threats, advances in malaria prevention have delivered significant gains. The expanded rollout of next-generation mosquito nets, improved diagnostics, and WHO-recommended vaccines prevented an estimated 170 million cases and one million deaths in 2024.
Since the first malaria vaccine was introduced in 2021, 24 countries have added it to routine childhood immunisation. Seasonal malaria chemoprevention has also grown dramatically, now reaching 54 million children annually across 20 countries—up from just 200,000 in 2012.
Progress toward global elimination continues, with 47 countries and one territory now certified malaria-free. In 2024, Cabo Verde and Egypt joined the list, followed by Georgia, Suriname, and Timor-Leste in 2025.
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Cases rising as resistance spreads
Even with these advances, global malaria mortality remains far above elimination targets. The disease caused 13.8 deaths per 100,000 people in 2024—three times the global target of 4.5.
WHO Director-General Tedros Adhanom Ghebreyesus said the world is at a turning point.
“New tools give us renewed hope, but the challenges remain substantial,” he warned. “Rising cases and deaths, expanding drug resistance, and funding gaps risk reversing two decades of progress.”
Emerging evidence suggests the drugs paired with artemisinin in combination therapies are also losing effectiveness. Diagnostic tools are further compromised by parasites with pfhrp2 gene deletions, reducing the reliability of widely used rapid diagnostic tests.
Climate change, conflict worsen the crisis
Extreme weather linked to climate change is reshaping mosquito habitats, creating ideal conditions for outbreaks. Droughts, floods and heat waves have shifted malaria transmission patterns across Africa and Asia, while conflict and political instability continue to disrupt health services. These disruptions delay diagnosis, reduce access to treatment and limit preventive interventions such as indoor spraying and bed net distribution.
Funding far below global needs
Global funding for malaria control reached US$3.9 billion in 2024—less than half of the US$9.3 billion needed for 2025. Reductions in Official Development Assistance have strained health systems, leading to stock-outs of medicines, weakened disease surveillance and delayed intervention campaigns.
Dr Martin Fitchet, CEO of Medicines for Malaria Venture, urged urgent action.
“The World Malaria Report is unequivocal: drug resistance is spreading. Our response must be just as strong—developing new treatments with new modes of action.”
Kenya struggles with high-burden regions
Kenya has made steep progress over the past decade, but malaria remains a major health threat in high-transmission regions. National malaria deaths fell from 15,061 in 2015 to 1,060 in 2023—a 93 per cent reduction. Malaria prevalence has also dropped from around 8 per cent to 6 per cent nationwide.
Cases fell by nearly 18 per cent in 2024 alone, reflecting the expanded use of insecticide-treated nets, indoor spraying, improved antimalarial therapies and the gradual rollout of malaria vaccines.
However, counties around Lake Victoria, the coastal belt and parts of western Kenya continue to record high infection rates. Turkana County remains one of the hardest hit, with prevalence far above national averages due to favourable mosquito breeding conditions and persistent funding gaps.
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The road ahead
Global health leaders warn that without urgent investment, malaria could rebound to levels not seen in decades. The development of new therapies—such as the first non-artemisinin combination drug Ganaplacide–Lumefantrine—offers promise, but widespread deployment will require sustained political and financial commitment.
A malaria-free world remains possible, experts say, but only if countries and global partners intensify efforts to counter resistance, strengthen surveillance, and expand access to lifesaving vaccines and treatments.
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