The World Health Organisation (WHO) has warned that progress against malaria is at serious risk as anti-malarial drug resistance spreads in Africa, funding declines, and surveillance systems weaken. The findings were released ahead of the publication of the World Malaria Report 2025.
Speaking from WHO headquarters in Geneva, Dr. Daniel Ngambije, Director of Malaria and Neglected Tropical Diseases, said global malaria interventions have saved 14 million lives between 2000 and 2024, yet the disease remains one of the world’s deadliest.
In 2024 alone, the organisation estimates more than 280 million malaria cases and over 600,000 deaths, with 95% of the burden occurring in Africa, mostly among young children and pregnant women.
“Too many people are still dying from a preventable and curable disease,” Dr. Ngambije said, stressing that emerging anti-malarial drug resistance now poses one of the most acute threats to malaria control efforts on the continent.
According to WHO data presented by Dr. Arnaud Lemenach, lead author of the report, eight African countries have confirmed or suspected partial resistance to artemisinin, the cornerstone of WHO-recommended malaria treatment.
Confirmed cases are in Rwanda, Uganda, Eritrea, and Tanzania.
Dr. Lemenach warned that resistance is also emerging against the partner drugs used alongside artemisinin. Without strong surveillance and rapid policy adjustments, Africa could face declining treatment efficacy similar to the chloroquine crisis of the 1980s and 1990s.
Dr. Charlotte Rasmussen, WHO’s technical officer for anti-malarial drug resistance, emphasised that resistance “can spread quickly in the background, long before treatment failures are reported,” underscoring the need for improved molecular surveillance and routine efficacy studies.
The report shows that malaria funding fell to US$3.9 billion in 2024, less than half of what is required to stay on track with the global malaria strategy.
Cuts to official development assistance (ODA) in 2025 have already disrupted routine surveillance, delayed surveys, and threatened supplies of nets, diagnostics, and medicines.
“When funding decreases, history tells us that resurgence is likely,” Dr. Lemenach said. Many malaria-endemic countries have scrambled to protect key interventions such as distribution of insecticide-treated nets (ITNs) and seasonal malaria chemoprevention (SMC), but significant gaps remain.
Resistance to pyrethroids, the main class of insecticides used in mosquito nets has now been detected in 48 countries in the last five years. WHO also noted increasing cases of gene deletions in Plasmodium falciparum parasites, which undermine the accuracy of rapid diagnostic tests.
Despite the challenges, experts highlighted important gains:
84% of nets delivered in 2024 in sub-Saharan Africa were next-generation ITNs designed to overcome insecticide resistance.
More children than ever received seasonal or perennial malaria chemoprevention.
17 countries have now introduced malaria vaccines, with more than 10 million doses delivered through UNICEF. Seven additional countries began vaccination in 2025.
Dr. Martin Fitchett, CEO of Medicines for Malaria Venture (MMV), noted that innovation is essential to outpace parasite evolution. He highlighted recent Phase III trial results for ganaplacide-lumefantrine, the first non-artemisinin malaria medicine in 25 years, which shows promise against resistant strains.
“History and biology tell us that existing medicines will eventually fail,” Dr. Fitchett said. “Our long-term victory depends on developing the next generation of anti-malarial medicines.”
Asked whether the situation is likely to deteriorate next year, WHO officials said outcomes will depend largely on how countries and donors respond to the current threats.
“If there is no good coverage of preventive tools and treatment, the situation might worsen,” Dr. Ngambije said. He added that the world is currently “three times off-track” from the 2025 global targets for reducing malaria cases and deaths.
WHO urged governments to reinforce political leadership, invest in surveillance, expand access to prevention tools, and scale up new technologies, particularly in the countries that carry the heaviest burden.
“This is the time for countries to lead their malaria response,” Dr. Ngambije said. “Political will must translate into resources and action.”