Uganda is grappling with a worsening malaria crisis as the World Health Organization (WHO) warns that Africa is entering a dangerous era of rising malaria cases, declining funding, and rapidly spreading drug resistance. Uganda is listed among the highest-risk countries.
During the launch of the World Malaria Report 2025, WHO confirmed that Uganda is one of four African countries with confirmed partial resistance to artemisinin—the core ingredient in the standard malaria treatment used nationwide.
The warning comes at a time when Uganda already bears one of the continent’s heaviest malaria burdens. Public health data shows that over 5,000 Ugandans died of malaria in 2024, with children under five and pregnant women most affected.
Malaria continues to place immense pressure on the country’s health system, accounting for 30–40% of outpatient visits and 25% of hospital admissions, according to the Ministry of Health.
WHO officials highlighted that drug resistance spreads silently, often long before clinics notice treatment failures. This means Uganda may already be facing a larger threat than current reports suggest.
“Resistance can spread quickly in the background, long before treatment failures are reported,” said WHO’s anti-malaria drug resistance expert, Charlotte Rasmussen.
Partial resistance to artemisinin poses serious risks: treatment may no longer fully clear the malaria parasite, children may fall sick again soon after treatment, and adults with severe malaria could face higher risks of death. Health facilities, already struggling with stockouts, may see more treatment failures and hospital admissions.
Globally, the African region carries 95% of the world’s malaria cases and deaths, with Uganda consistently among the most heavily affected nations. Dr. Daniel Ngambije, WHO’s Director of Malaria and Neglected Tropical Diseases, warned that rising resistance threatens to reverse decades of progress.
“Too many people are still dying from a preventable and curable disease. Drug resistance is one of the most acute threats we face today,” Dr. Ngambije said.
The report also highlighted funding challenges. Global malaria spending fell to US$3.9 billion in 2024—less than half of what is required. WHO noted that cuts in donor funding, particularly Official Development Assistance (ODA), have disrupted malaria surveillance and could lead to shortages of mosquito nets, drugs, and test kits in 2025.
For Uganda, which relies heavily on Global Fund support for malaria commodities, these cuts could result in more ACT stockouts, delayed distribution of mosquito nets, reduced diagnostic capacity, and fewer surveillance surveys to detect drug resistance early.
“When funding decreases, history tells us that malaria resurges,” warned Dr. Arnaud Lemenach, a lead author of the report.
Despite the challenges, WHO highlighted promising developments. In 2024, 84% of mosquito nets distributed were next-generation nets designed to combat insecticide-resistant mosquitoes. Seventeen countries have introduced malaria vaccines, with more than 10 million doses delivered globally. Uganda plans a nationwide vaccine rollout once financing is secured.
Additionally, a new non-artemisinin drug, ganaplacide, which targets resistant parasites, is in advanced development. Dr. Martin Fitchett of Medicines for Malaria Venture said innovation is the key to long-term malaria control.
“History and biology tell us that existing medicines will eventually fail. Our long-term victory depends on the next generation of anti-malarial medicines,” Dr. Fitchett said.
In northern and eastern Uganda, where malaria transmission is highest, families continue to face repeated illness, long hospital waits, and financial hardship. A child with malaria still faces a real risk of death if treatment is delayed or if the drugs fail.
Uganda’s health authorities and international partners now face urgent decisions to strengthen malaria prevention, improve treatment access, and combat the growing threat of drug resistance before it escalates further.