In 25 years, investment in the fight against malaria has prevented two billion infections and 13 million deaths, most of them in Africa, which carries nearly all of the burden of the disease. But as cases rise for a fifth year in a row and US funding is cut, experts warn that progress is slowing. Reaching the UN goal of ending malaria by 2030 now looks increasingly uncertain.
Despite major gains, the World Health Organization (WHO) said efforts to stop malaria remain too slow. The disease killed 597,000 people in 2023.
A WHO report released in December showed 263 million cases in 2023, 11 million more than in 2022. It was the fifth year in a row that cases increased.
Africa is the worst-hit region, accounting for around 95 percent of malaria deaths each year.
In 2023, Africa’s malaria death rate was estimated at 52 per 100,000 people – more than twice the target set by the global strategy to end malaria by 2030.
World Malaria Day 2025 comes with the theme "Malaria ends with us: reinvest, reimagine, reignite".
The WHO is calling for "stepped up political and financial commitment to protect the hard-won gains against malaria".
Recent progress includes new tools, such as mosquito nets treated with two insecticides instead of one, a second malaria vaccine, and research into making human blood toxic to mosquitoes.
"Innovation is absolutely essential," Philippe Duneton, director of Unitaid, the organisation responsible for facilitating access to treatments for malaria told RFI.
He said one of the main challenges is "the problem of mosquito resistance to insecticides and parasite resistance to drugs".
More countries are making malaria control and elimination a national priority, as can be seen by the Yaoundé Declaration, signed in March 2024 by African Ministers of Health from 11 high burden countries.
In Cameroon, where malaria kills nearly 11,000 children in the country each year, the government received more than 950,000 doses of the vaccine in 2024.
According to the country's Expanded Programme on Immunisation (EPI), the administration of initial doses has been a success with 70 percent coverage.
RFI’s correspondent in Yaoundé said doubts about the vaccine have started to fade, but fewer than 50 percent have had the third dose.
Despite this, the vaccination rate for subsequent doses is less convincing, with less than 50 percent for the third dose.
According to Shalom Ndoula Tchokfe, secretary of the EPI, the implementation of a new vaccination schedule could explain this.
"These are unusual appointments for mothers. Because the child has to be brought in at six months, seven months, and nine months," he told RFI.
Data from Cameroon’s Health Ministry shows a sharp drop in child deaths from malaria in the 42 health districts where the vaccine has been used.
But Ndoula Tchokfe said it is too soon to credit the vaccine alone.
"We cannot say that it is attributable to vaccination only because there have also been several malaria control efforts that have been strengthened, including season chemical prevention and other strategies put in place by the authorities," he says.
Cameroon will receive new doses of vaccine next September.
On Friday, Mali will join 19 other African countries in introducing vaccines through the GAVI vaccine alliance.
Malaria vaccines have been rolled out on the African continent since April 2019 – first in Malawi, with Kenya and Ghana following suit.
However, humanitarian groups are worried about the impact of US President Donald Trump's move to freeze America's foreign aid budget, while other donors, notably in Europe, have also made cuts to their financing.
Although Washington announced some exemptions for the fight against malaria, it doesn't reassure those on the ground.
According to the Malaria Atlas Project consortium of researchers, a year of a complete freeze in US funding would result in 15 million more malaria cases and 107,000 more deaths.
On the African continent, malaria kills approximately 500,000 people each year.
Many of the countries most affected by the disease are about to enter the rainy season.
Duneton says funding cuts have already caused some "delays and shortages in the delivieries of mosquito nets in Sahel countries".