Africa’s malaria fight faces a funding crisis

In 2021, nearly half of sub-Saharan African countries depended on external financing for over a third of their health spending. But donor fatigue and competing global challenges, like climate change and geopolitical instability, are straining malaria control efforts. These growing funding gaps now threaten decades of progress and could derail efforts toward malaria eradication.

Though not a new problem, Africa’s healthcare funding crisis is becoming more severe. As financial support dwindles, the continent’s ability to combat deadly diseases like malaria is being tested more than ever.

Malaria remains one of the world’s leading public health threats. In 2023, the World Health Organisation (WHO) recorded an estimated 263 million malaria cases and 597 000 deaths globally — 11 million more cases than in 2022. Africa bore the brunt, accounting for 94% of cases and 95% of deaths. Today, a child under five in Africa dies from malaria approximately every 90 seconds.

Yet, malaria control efforts since 2000 have averted over 2 billion cases and saved nearly 13 million lives. Advances in prevention and treatment, such as insecticide-treated nets, rapid diagnostic tests, artemisinin-based therapies, and vaccines, have been crucial to this success.

But progress has stalled since 2017. Without renewed investment, the risk isn’t just stagnation — it’s reversal. New and emerging threats, including drug and insecticide resistance, evolving mosquito behaviour, and undetectable parasite strains, further complicate the fight. Climate change is shifting transmission patterns, and the spread of the invasive Asian mosquito Anopheles stephensi—especially in urban areas—poses a growing risk. Add cross-border transmission and aid shortfalls, and it’s clear the fight against malaria is at a critical turning point.



Time to reinvest, reimagine, reignite

World Malaria Day 2025 calls for action under the theme “Malaria ends with us: reinvest, reimagine, reignite” the message is clear: Africa must lead with renewed investment, innovation and political will.



Reinvest: Prevention saves lives and money

Prevention remains the most cost-effective malaria intervention. A long-lasting insecticidal net costs between $4 and $7 and offers years of protection. In contrast, treating one severe malaria case can cost hundreds of dollars, often requiring hospitalisation.

Malaria can consume up to 40% of public health budgets in high-burden countries. In Tanzania, it accounts for 30% of the disease burden. The broader economic impact — lost productivity, absenteeism, and healthcare costs — is staggering. Preventative tools like bed nets, chemoprevention, and health education aren’t just humane; they’re financially sound.



Reimagine: Adapt to new realities

The malaria landscape is changing. Resistance, urbanisation, and climate change require a shift in strategy. Countries must scale up innovations like the RTS,S/AS01 vaccine and new-generation mosquito nets.

But relying solely on imported solutions is no longer enough. Africa must invest in its own research, development, and local production of malaria tools. This means funding local innovation, strengthening regulatory systems, and building homegrown manufacturing capacity.

Leadership within national malaria programmes must also evolve, focusing on agility, evidence-based decision-making, and readiness to respond to changing dynamics.



Reignite: Empower communities, strengthen collaboration

The frontlines of malaria control are found in Africa’s communities. Community health workers are already essential in delivering testing, treatment, and education in remote areas. With further training, they can support broader health initiatives, increasing system resilience and reducing dependence on external aid.

Integrating malaria efforts into primary healthcare services enhances continuity and community trust. Every malaria test or bed net delivered by a local health worker builds ownership and sustainability.

Collaboration across governments, international partners, and local actors is also key. Border coordination, shared resources, and united political commitment can make interventions more effective.



Inaction has a high price

Africa’s malaria crisis reflects a wider health system challenge. By 2030, the continent will need an additional U$371 billion annually — about U$58 per person — to deliver basic primary care.

In 2023, U$8.3 billion was required globally for malaria control and elimination. Only U$4 billion was raised. The shortfall has doubled since 2019, leaving millions without access to lifesaving tools.

Closing the gap isn’t just about spending more — it’s about spending smarter. Prevention, local innovation, and stronger health systems offer the best path forward.

The responsibility is shared. African governments must lead with investment and policy reform. Global partners must support—without dominating. And communities must be empowered to protect their own health.

The fight against malaria is not yet lost, but renewed commitment is urgent. Without it, the gains of the past two decades risk being erased. – The Conversation