Despite huge progress over the last two decades in halving the death rate, every minute a child still dies from malaria. A critical crossroads awaits the global malaria fight in 2025. Since this report was written, the geopolitical landscape has become even more challenging. Reductions in official development assistance (ODA) from G7 governments threaten upcoming replenishments for key global health institutions, and a worsening current situation for malaria with the future of many programmes uncertain. Recently published modelling data projects that if vital organisations, like the Global Fund to Fight AIDS, Tuberculosis and Malaria (Global Fund), fail to raise increased funding for malaria the world will experience a resurgence between now and 2030.
This report demonstrates how a resurgence of malaria threatens not only those countries affected but global health security everywhere. When malaria thrives, it weakens health systems. It impinges on the capacity to test, diagnose and treat a myriad of other diseases and potentially dangerous pathogens. It can mask outbreaks of other illnesses which in turn also strains health systems because of the delay and uncertainty caused by not having a clear diagnosis. Our research has found that a third of fevers still go undiagnosed in sub-Saharan Africa. As malaria symptoms are similar to so many other diseases and account for such a high number of the fevers, these undiagnosed fevers could be masking a deadly new threat with pandemic potential.
The research conducted and expert interviews summarised in this report demonstrate how investments in malaria have supported the building of stronger and more climate-resilient health systems, have built stronger disease surveillance systems which can respond to new threats, increased global research capacity and laid the groundwork for the COVID-19 vaccine development, improved diagnostic capabilities and strengthened supply chains as well supported the drive towards local manufacturing. Malaria is a pathfinder for pandemic prevention, preparedness and response (PPPR) and the lessons learnt from malaria on PPPR are many. Continued investment in malaria control is vital to bolster PPPR and to strengthen global health security.
Our research shows that there is great hope for the malaria fight despite the challenges. The progress made in increasing access to tools and reducing the burden have strengthened the resiliency of many countries. This hope should be coupled with even greater optimism given the strength the malaria innovation pipeline provides to take the world closer to ending one of the world’s deadliest diseases and freeing up resources to tackle other crises. Never has there been such a powerful set of tools to fight malaria: from vaccines to next generation mosquito nets and new antimalarial drugs. Scientists in Africa and across the world are working together to develop the game-changing innovations that will wipe out malaria once and for all with trials underway for innovative tools like genetically modified mosquitoes. The need to get these tools to those who need them and prepare for the next wave of scientific breakthroughs goes hand in hand with the need, and indeed creates an opportunity, to strengthen PPPR.
As the world faces a malaria resurgence that threatens us all, 2025 offers an opportunity to take action and get us back on track for elimination and build on the gains of the last two decades. To prevent a possible resurgence, world leaders across Africa, the G7 and beyond who have led the fight to date must increase funding for malaria. Bold commitments are required to support the Global Fund and Gavi, The Vaccine Alliance, alongside efforts unlock climate finance to address the growing risk climate change creates for malaria elimination. In doing so, we can create a safer more prosperous world for all.